Cryoprecipitate

Cryoprecipitate, also called cryo for short, or Cryoprecipitate Antihemophilic factor (AHF), is a frozen blood product prepared from blood plasma.^[1] To create cryoprecipitate, plasma is slowly thawed to 1–6 °C. A cold-insoluble precipitate is formed, which is collected by centrifugation, resuspended in a small amount of residual plasma (generally 10–15 mL) and then re-frozen for storage. Cryoprecipitate contains fibrinogen, Factor VIII, Factor XIII and vWF. In many clinical contexts, use of cryoprecipitate has been replaced with use of clotting factor concentrates (where available), but the whole form is still routinely stocked by many hospital blood banks. Cryo can be stored at −18 °C or colder for 12 months from the original collection date^[1] or up to 36 months in Europe if stored below -25 °C.^[2] After thawing, single units of cryo (or units pooled using a sterile method) can be stored at 20–24 °C for up to 6 hours. If units of cryo are pooled in an open system, they can only be held at 20–24 °C for up to 4 hours.^[3] Presently cryo cannot be re-frozen for storage after it is thawed for use if it is not transfused.

Compatibility testing (cross-matching) before transfusion of cryoprecipitate are not necessary. However, cryoprecipitate should preferably be ABO compatible with the recipient's red cells. ABO-incompatible cryoprecipitate can be used with caution, particularly with large volumes. If a large volume of ABO-incompatible cryoprecipitate is used, the recipient may develop a positive direct antiglobulin test and, very rarely, mild haemolysis. Matching for RhD type is not necessary.