Can Storage of Thawed Cryoprecipitate Be Extended to More than Six Hours?

Abstract

Fresh-frozen plasma (FFP) and cryoprecipitate both contain Factors I and VIII, however thawed FFP may be stored at 1-6 degrees C for 24 hours, but thawed cryoprecipitate may only be stored at 1-6 degrees C for six hours when used for Factor VIII content. To determine whether it would be safe and effective to extend the storage period of thawed cryoprecipitate from 6 to 24 hours, Factor VIII (and fibrinogen) levels were measured in 25 units of cryoprecipitates immediately on thawing and at 6 hours and 24 hours thereafter. The Factor VIII activity level decreased to 86% of the original activity level within 6 hours, but the drop between 6 and 24 hours was relatively small. Eighty percent of the original activity was still present at 24 hours after thawing. The fibrinogen level decreased to 87% of the original level within 6 hours but remained stable between 6 and 24 hours. Additional testing showed that fibrinogen levels remained stable between 6 and 74 hours. These data suggested that the storage of thawed cryoprecipitate might be extended to 24 hours when this blood product is used for Factor VIII content and to 74 hours when it is used for fibrinogen content. Furthermore, the lack of prohibition on the use of cryoprecipitate that has been thawed for more than six hours and stored at 4 degrees C for its fibrinogen content seems reasonable.

The effect of repeated freezing and thawing on levels of vitamin K-dependent coagulation factors and fibrinogen in fresh frozen plasma

“…[3] The activity of clotting factors, including vitamin K-dependent proteins[12] and fibrinogen[13] after thawing at different conditions[1415] has also been investigated. Methods of freezing and the rapidity of freezing and thawing, such as microwave versus water bath,[16–18] have been examined.…”

Vitamin K‐dependent coagulation factors and fibrinogen levels in FFP remain stable upon repeated freezing and thawing

“…The stability of clotting factors for different lengths of time at –20°C, –40°C, 20 and –65°C was tested, and it is now accepted that the latter can be stored for up to 7 years 1 . The activity of clotting factors, including vitamin K‐dependent proteins 10 and fibrinogen 21 after thawing at different conditions 22,23 were also investigated. Methods of freezing and the rapidity of freezing and thawing, such as microwave versus waterbath, 24–28 were examined.…”

Cryoprecipitate transfusion: assessing appropriateness and dosing in trauma

“…Due to the fibrinogen's diffusion phase half-life of 12 hours, it is recommended that CRYO infusions be administered every 12 hours for patients with congenital fibrinogen deficiency where fibrinogen concentrates are not available. As oppose to the reduced factor VIII recovery, fibrinogen activity remains stable with 87% of the original content at time of thawing of fibrinogen recovered at 24 hours of liquid storage (Saxena et al, 1990). …”