Plasma, Cryoprecipitate Reduced
This is the formal name for the plasma product that also has been called “cryosupernatant” or more commonly, “CRYO-reduced Plasma (CRP).” When Fresh Frozen Plasma (FFP) is thawed at 1-6C in a refrigerator, a small amount of the plasma “precipitates” (becomes slushy or solid) in the bag. This semi-solid portion of plasma under these conditions is known as cryoprecipitate (CRYO) and has one main clinical use (fibrinogen replacement). The remainder of the plasma, however, can be refrozen (within 24 hours) and re-labeled as “Plasma, Cryoprecipitate-Reduced.” This product is deficient in the factors contained in CRYO, including fibrinogen, Factor VIII, and von Willebrand Factor (vWF) in particular. In addition, the larger multimers of vWF are not well-preserved in this product. However, the von Willebrand factor cleaving enzyme ADAMTS13 is quite well preserved in CRP. As a result, the only real indication for the use of this product is Thrombotic Thrombocytopenic Purpura (TTP). These patients are most commonly treated with plasma exchange with replacement by FFP or PF24. However, if that treatment fails to induce remission within a week to ten days, some have switched to a trial of CRP as replacement fluid instead. Unfortunately, available studies have not shown CRP to be substantially more effective in this scenario.
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