Cryoprecipitate Storage and Transport Guidelines
Cryoprecipitate must be stored at -25°C or below in a frozen state, and once thawed, it can be kept at ambient temperature for up to 4 hours and should not be refrigerated again. 1
Storage Requirements
Frozen Storage
- Cryoprecipitate must be maintained at a core temperature below -25°C
- Can be stored frozen for up to 36 months 1
- Requires specialized freezers capable of maintaining this temperature consistently
Thawing Process
- Thawing methods include:
- Dry ovens
- Microwave ovens
- Water bath methods 1
- Thawing should be done carefully to preserve coagulation factor activity
- Cryoprecipitate is produced by thawing FFP at 1-6°C, which precipitates high-molecular-weight plasma proteins 2, 3
Post-Thaw Handling
Time and Temperature Limitations
- Once thawed, cryoprecipitate can be kept at ambient temperature for only 4 hours 1
- Should not be refrigerated after thawing 1
- Must be transfused within this 4-hour window to ensure optimal coagulation factor activity
Transport Considerations
- Transport time outside temperature-controlled environments should be minimized
- Must be administered using a standard blood giving set with a 170-200 μm filter 1
- Typical infusion rate is 10-20 ml/kg/h (30-60 minutes for one pool) 1
Quality Standards
- 75% of cryoprecipitate units should contain at least 140 mg of fibrinogen
- Pooled cryoprecipitate (from five donations) should contain >700 mg of fibrinogen 1
- Each single unit contains 400-450 mg of fibrinogen 1
- Contains concentrated factor VIII, von Willebrand factor, fibrinogen, factor XIII, and fibronectin 1, 2, 3
Special Considerations
Pediatric Use
- Cryoprecipitate for use in those born in 1996 or later (in the UK) is made from FFP sourced outside the UK and has undergone viral inactivation with methylene blue 1
- Available as single units for smaller children and pooled units for older children and young adults 1
Recent Research on Extended Storage
While current guidelines limit post-thaw storage to 4 hours at ambient temperature, recent research suggests potential for extended storage:
- Studies have shown that refrigerated storage (1-6°C) of thawed cryoprecipitate for up to 24 hours maintains fibrinogen levels and von Willebrand factor activity, though Factor VIII activity decreases significantly 4
- Some research indicates fibrinogen concentration and function may remain adequate for up to 35 days when refrigerated 5
- Extended storage at 2-6°C for up to 5 days has shown maintenance of coagulation factors above therapeutic ranges 6
However, current clinical guidelines still recommend the 4-hour limit at ambient temperature, and these research findings have not yet been incorporated into standard practice.
Common Pitfalls to Avoid
- Refrigerating thawed cryoprecipitate (should be kept at ambient temperature)
- Exceeding the 4-hour post-thaw window for administration
- Using improper filters for administration
- Failing to complete transfusion within the recommended timeframe
- Not properly monitoring for precipitation in stored units (precipitation may occur in refrigerated samples but can be resuspended upon warming in a 37°C water bath) 5
By adhering to these storage and transport guidelines, the efficacy of cryoprecipitate can be maintained, ensuring optimal outcomes when used for its various clinical indications.