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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/11/12 13:46:36」(JST)

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Cryoprecipitate, also called "Cryoprecipitated Antihaemophilic Factor", "Cryoprecipitated AHF", and "cryo" for short, is a frozen blood product prepared from plasma. To acquire cryoprecipitate, the fresh frozen plasma should be centrifuged and the precipitate should be collected.

It is often transfused as a four to six unit pool instead of as a single product. Many uses of the product have been replaced by factor concentrates, but it is still routinely stocked by many hospital blood banks.

Unlike fresh frozen plasma, compatibility testing is not strictly necessary, but cryo is given as ABO compatible when possible. (Compatibility is reversed for plasma products: O- type is the universal plasma recipient and AB+ type is the universal plasma donor.)

Composition

Each unit (around 10 to 15 mL) typically provides:^[1]

Fibrinogen 150-250 mg with a half-life of 100-150 hours
Factor VIII 80-150 U with a half-life of 12 hours
von Willebrand factor 100-150 U with a half-life of 24 hours
Factor XIII 50-75 U with a half-life of 150-300 hours.

Cryoprecipitate also contains fibronectin; however there are no clear indications for fibronectin replacement.

US standards require manufacturers to test at least four units each month, and the products must have an average of 150 mg or more of fibrinogen and 80 IU of factor VIII.^[2] Individual products may actually have less than these amounts as long as the average remains above these minimums. Typical values for a unit are substantially higher, and aside from infants it is rare to transfuse just one unit.

Indications

Indications for giving cryoprecipitate include:^[3]

Haemophilia - Used for emergency back up when factor concentrates are not available.
von Willebrands's disease - Not currently recommended unless last reserve. ddAVP is first line, followed by factor concentrates.
Hypofibrinogenaemia (low fibrinogen levels), as can occur with massive transfusions
Afibrinogenemia
Bleeding from excessive anticoagulation - Fresh frozen plasma contains most of the coagulation factors and is an alternative choice when anticoagulation has to be reversed quickly.
Massive haemorrhage - RBCs and volume expanders are preferred therapies.
Disseminated intravascular coagulation
Uremic bleeding tendency

Adverse Effects

Adverse effects reported with the usage of cryoprecipitate include hemolytic transfusion reactions, febrile non-hemolytic reactions, allergic reactions (ranging from urticaria to anaphylaxis), septic reactions, transfusion related acute lung injury, circulatory overload, transfusion-associated graft-versus-host disease, and post-transfusion purpura. ^[4]

References

^ http://reference.medscape.com/drug/cryo-cryoprecipitate-999498#10
^ "Circular of Information For the Use of Human Blood and Blood Components" (PDF). Archived from the original (PDF) on 2008-02-27. Retrieved 2008-02-28.
^ Erber WN, Perry DJ (2006). "Plasma and plasma products in the treatment of massive haemorrhage". Best Pract Res Clin Haematol 19 (1): 97–112. doi:10.1016/j.beha.2005.01.026. PMID 16377544.
^ http://reference.medscape.com/drug/cryo-cryoprecipitate-999498#4

UpToDate Contents

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English Journal

Blood and bombs: the demand and use of blood following the London Bombings of 7 July 2005 - a retrospective review.

Glasgow SM, Allard S, Doughty H, Spreadborough P, Watkins E.SourceTrauma Sciences, Blizard Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK.
Transfusion medicine (Oxford, England).Transfus Med.2012 Aug;22(4):244-50. doi: 10.1111/j.1365-3148.2012.01173.x.
Mass casualty events (MCE) present health systems with a sudden demand on key services. The overall objective of this study was to describe the experience of the National Blood Service (NBS) following the largest UK MCE in recent times. Data was collated from the NBS database and directly from the h
PMID 22809430

Protein composition of clots detected in pooled cryoprecipitate units.

Macphee M, Wilmer B, Beall D, Moroff G.SourceFrom STB LifeSaving Technologies and the American Red Cross, Holland Laboratory, Rockville, Maryland.
Transfusion.Transfusion.2012 Jul 15. doi: 10.1111/j.1537-2995.2012.03778.x. [Epub ahead of print]
BACKGROUND: On rare occasions, upon thawing of stored cryoprecipitate components, clots are observed on visual inspection. Although it has been assumed that the clot reflects fibrinogen to fibrin conversion, there are few published studies that document that this assumption is correct. Our studies w
PMID 22804740