Determinants of Factor VIII Recovery in Cryoprecipitate

Kasper, Carol K.; Myhre, Byron A.; McDonald, J. David; Nakasako, Yukio; Feinstein, D. I.

doi:10.1046/j.1537-2995.1975.15476034550.x

Cited by 39 publications

(15 citation statements)

References 2 publications

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“…However, a statistical significance could not be established because of the small sample size (N ¼ 7) of those more than 6-month-old samples ( Table 2). This finding was similar to the study of Kasper et al [13] demonstrating an average loss of FVIII activity of 36% per bag of cryoprecipitate if stored for 12 months instead of 2 months. Our data suggests the use of cryoprecipitates of at most 6 months old storage when FVIII content is needed.…”

Section: Discussionsupporting

confidence: 91%

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Thawed cryoprecipitate stored for 6 h at room temperature: a potential alternative to factor VIII concentrate for continuous infusion

et al. 2004

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Continuous infusion (CI) of factor VIII concentrates has been demonstrated to be cost-effective method in maintaining stable levels of FVIII activity in haemophilia A patients with major bleeding or undergoing major surgery. Cryoprecipitates remain the major source of FVIII in developing countries-like the Philippines because of limited availability and high cost of concentrates. To support the use of cryoprecipitate as alternative to FVIII concentrate for CI in centres with no factor concentrates, FVIII levels in 37 bags of random cryoprecipitate were measured at 0, 2, 4 and 6 h after thawing, kept at room temperature with bacteriological culture studies performed on the sixth hour. The mean FVIII content at hour 0 was 108.10 U per bag. Type ORh+ blood had lower FVIII content (+/-78.91 U per bag) compared with blood types ARh+ (+/-121.64 U per bag) and BRh+ (+/-117.04 U per bag). The units stored <6 months had higher FVIII content (+/-117.74 U per bag) compared with those stored for over 6- but <12-months (+/-66.77 U per bag). The mean rate of decline of FVIII activity at 2, 4 and 6 h was statistically significant at 10.35% (P = 0.000), 21.49% (P = 0.000) and 29.41% (P = 0.000) from baseline, respectively, using the paired t-test. Similar finding was found across different blood types and storage duration. Only one of 37 bags grew Staphylococcus aureus on day 10 of incubation.

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Section: Discussionsupporting

confidence: 91%

“…This finding was similar to the study of Kasper et al . [13] demonstrating an average loss of FVIII activity of 36% per bag of cryoprecipitate if stored for 12 months instead of 2 months. Our data suggests the use of cryoprecipitates of at most 6 months old storage when FVIII content is needed.…”

Section: Discussionmentioning

confidence: 99%

Thawed cryoprecipitate stored for 6 h at room temperature: a potential alternative to factor VIII concentrate for continuous infusion

et al. 2004

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“…continuous mixing of blood during collection; minimizing the time from donation of plasma to freezing; rapid re-freezing of CRYO on dry-ice; and limiting the duration of CRYO storage (Kasper et al, 1975). Higher donor baseline levels of factor VIII are also associated with improved in vivo recovery (Kasper et al, 1975).…”

Section: Manufacturing Proceduresmentioning

confidence: 99%

“…Higher donor baseline levels of factor VIII are also associated with improved in vivo recovery (Kasper et al, 1975). Despite increased levels of factor VIII in exercised donors, this recommendation failed to translate into superior post-infusion in vivo recovery of factor VIII due to the rapid clearance of the "exercise" factor VIII (van Gastel et al, 1973).…”

Section: Manufacturing Proceduresmentioning

confidence: 99%

Cryoprecipitate transfusion: assessing appropriateness and dosing in trauma

Nascimento¹,

Rizoli²,

Rubenfeld³

et al. 2011

Transfusion Medicine

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Cryoprecipitate is commonly used outside guidelines. In trauma, the appropriate cryoprecipitate dose and its impact on plasma fibrinogen levels are unclear.This retrospective study aims to evaluate: (1) the appropriateness of cryoprecipitate transfusion in trauma; and (2) the plasma fibrinogen response to cryoprecipitate transfusion during massive transfusion in trauma.Fibrinogen levels of < 1.0 g/L within 2 and 6 hours of cryoprecipitate transfusion were used for assessing appropriateness. Out of 394 events, 238 (60%) and 259 (66%) were considered appropriate using 2 and 6 hour criteria, respectively. A dose of 8.7 (±1.7) units caused a mean increase in fibrinogen levels of 0.55 (±0.24) g/L, or 0.06g/L per unit.In our hospital, where transfusion guidelines and policies for rapid blood product and laboratory turnaround times exist, it is possible to achieve high rates of appropriateness for cryoprecipitate transfusion in trauma. The current recommended dose causes a modest increase in fibrinogen levels.iii

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“…Pool [32] tried several high-protein diluents for concentrate, including hemophilic plasma, human albumin, gelatin, and aged citrated human serum, and settled on the latter because the results of in vifro assays performed with that concentrate diluent approximated most closely the in vivo recovery findings. During the previous study of factor Vlll recovery in cryoprecipitate in this laboratory [33] the in vifro twostage assay of cryoprecipitate was found to be affected by the degree of pre-dilution in hemophilic plasma, and a ratio of one part cryoprecipitate to nine parts hemophilic plasma was associated with results correlating well with in vivo findings, wheras in vitro results with ratios of one to four or one to one did not correlate well with in vivo findings.…”

Section: Assay Methodsmentioning

confidence: 77%

In Vivo Recovery of Fviii:c in Hemophilic Patients

Kasper

1984

Scandinavian Journal of Haematology

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Average pre‐operative in vivo recoveries of factor VIII:C concentrate fell from 1967 to 1976, then improved, and fell again in the early 1980's. Average outpatient in vivo recoveries were studied from 1978‐83; the lowest values for two of three brands were seen in 1980. Standard in vivo recovery studies were performed with a 10 minute post‐infusion plasma sample only, but detailed tests in 39 patients indicated that the peak post‐infusion level after concentrate infusion occurred at 30 minutes rather than 10 minutes in 23 percent of recipients. Comparison of one‐ and two‐stage assay methods showed that higher in vivo recoveries were obtained when plasma samples were assayed with the two‐stage method. The major cause of discrepancies between observed and expected VIII:C recoveries, however, is believed to be inaccurate assessment of the VIII:C potency of various in‐house VIII:C references. Methods of in vitro assay of concentrates which adequately predict in vivo effect are needed.

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Determinants of Factor VIII Recovery in Cryoprecipitate

Cited by 39 publications

References 2 publications

Thawed cryoprecipitate stored for 6 h at room temperature: a potential alternative to factor VIII concentrate for continuous infusion

Thawed cryoprecipitate stored for 6 h at room temperature: a potential alternative to factor VIII concentrate for continuous infusion

Cryoprecipitate transfusion: assessing appropriateness and dosing in trauma

In Vivo Recovery of Fviii:c in Hemophilic Patients

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