A comparative evaluation of the quality of cryoprecipitate prepared from 350ml versus 450ml of whole blood and different methods of thawing of plasma: A prospective observational study.

Abstract

Cryoprecipitate is used in conditions like hypofibrinogenemia, massive transfusion with bleeding, and factor XIII deficiency. The current guidelines support the preparation of cryoprecipitate from 450ml whole blood. But 350ml of whole blood collection is expected from low body weight (<55kg) donors. However, no standardized criteria exist for preparing cryoprecipitate from 350ml of whole blood. This study compared the fibrinogen and factor VIII levels in cryoprecipitate units prepared from 350ml versus 450ml whole blood collection. The study also compared the fibrinogen and factor VIII levels prepared by circulating water bath versus blood bank refrigerator (BBR) thawing method. A total of 128 blood bags were equally divided into groups A and B for 450 and 350ml whole blood collection further subdivided into subgroups based on thawing methods. The fibrinogen and factor VIII yield were analyzed in the cryoprecipitates prepared from both groups. The factor VIII levels were significantly higher in cryoprecipitate made from 450ml whole blood collection (P=0.02). The BBR method of plasma thawing resulted in better fibrinogen recovery than the cryo bath method. Whereas vice versa in the case of factor VIII recovery. A weak but significant positive correlation was noted in factor VIII levels with the plasma volume. Over 75% of the cryoprecipitates prepared from 350ml whole blood passed the fibrinogen and factor VIII quality control criteria. So, 350ml whole blood collection from low body weight (<55kg) donors could be utilized to prepare cryoprcipitates. However, future clinical studies should focus on the cryoprecipitate's clinical efficacy prepared from 350ml of whole blood.