What is Cryoprecipitated AHF?

Cryoprecipitated AHF (Cryoprecipitated Antihemophilic Factor or CRYO)  is the cold-insoluble portion of plasma that precipitates when  FFP has been thawed between 1-6C.

CRYO contains:	Factor XIII	Factor VIII:vWF (von Willebrand Factor)
	Fibronectin	Factor VIII:C
	Fibrinogen

How to Make Cryoprecipitate:

	Platelet poor plasma from CPDA-1 or CPD whole blood unit that has been frozen to make FFP is allowed to thaw in a refrigerator at 1-6C overnight or about 8-10 hours until the plasma has a slushy consistency.  Technically, This is when approximately one tenth of the contents is still frozen. Centrifuge the plasma at 1-6C using a Heavy Spin to separate the plasma from the cryoprecipitate.
	Place centrifuged, thawed plasma in a plasma expressor and allow the supernatant to flow slowly into a transfer bag.  The cryoprecipitate paste will adhere to the side of the bag or to the ice.  The cryo will appear to be a small white mass in the original plasma bag. Units of CRYO can be pooled prior to freezing and storage.  If pooled promptly after preparation using aseptic technique and refrozen immediately, the resulting component is labeled " Cryoprecipitated AHF pooled" with the number of units pooled stated on the label.  The facility preparing the pool must maintain a record of each individual donor traceable to the unique pool number.
	Leave about 10-15mL of supernatant plasma in the bag for resuspending the cryoprecipitate after thawing. Refreeze the cryoprecipitate immediately.  Remember, cryoprecipitate must be refrozen within 1 hour of preparation and store at -18C or cooler.

Cryoprecipitated AHF can be used:

1. For controlling the bleeding associated with fibrinogen deficiency.
2. For treating Factor XIII deficiency.
3. To make "Fibrin Glue", a substance composed of cryoprecipitate and topical thrombin.   When combined, they produce an adhesive substance that, applied to a surgical site can reduced bleeding.  It is also know as the "Human Glue"
4. As a second -line therapy for von Willebrand's disease and hemophilia A.  Cryoprecipitate should be used only if viral-inactivated Factor VIII concentrates are not available for management of these patients.

Storage and Expiration of CRYO:

• Cryoprecipitate must be stored at -18C or colder, preferably -30C or colder.
• It expires 1 year from the date the of phlebotomy, not from the date the cryo was prepared.
• Once cryoprecipitate is thawed, it must be kept at room temperature (20-24C).   Administration must begin as soon as possible or within 6 hours after thawing.

Quality Control for CRYO:

• Cryoprecipitate is prepared from fresh frozen plasma from CPDA-1 or CPD whole blood at any time within the 12 month expiration of the fresh frozen plasma.
• Cryo should contain: minimum of 150 mg of fibrinogen and minimum of 80 IU (International Units) of Factor VIII (AHF).
• In test performed on pooled components, the pool shall contain a minimum of 150 mg of fibrinogen and 80 IU of coagulation Factor VIII times the number of components in the pool.

Other Products Associated with Cryoprecipitated AHF