Preselection of donors to improve the quality of cryoprecipitate

Authors

  • Peter A. Tomasulo MD,

    Corresponding author
    1. Department of Pathology, The Medical College of Wisconsin, Milwaukee
    2. Department of Medicine, The Medical College of Wisconsin, Milwaukee
    3. The Elser Hemostasis Laboratory of The Blood Center of Southeastern Wisconsin, Inc., Milwaukee
    4. Great Lakes Hemophilia Foundation, Milwaukee
    • Medical Director, The Blood Center of Southeastern Wisconsin, Inc., P.O. Box 10G, Milwaukee, WI 53201
    Search for more papers by this author
  • William Richards,

    1. The Elser Hemostasis Laboratory of The Blood Center of Southeastern Wisconsin, Inc., Milwaukee
    Search for more papers by this author
  • Marilyn Bailey,

    1. The Elser Hemostasis Laboratory of The Blood Center of Southeastern Wisconsin, Inc., Milwaukee
    2. Great Lakes Hemophilia Foundation, Milwaukee
    Search for more papers by this author
  • Mieczyslaw Gajewski,

    1. The Elser Hemostasis Laboratory of The Blood Center of Southeastern Wisconsin, Inc., Milwaukee
    Search for more papers by this author
  • Richard H. Aster,

    1. Department of Medicine, The Medical College of Wisconsin, Milwaukee
    2. The Elser Hemostasis Laboratory of The Blood Center of Southeastern Wisconsin, Inc., Milwaukee
    3. Great Lakes Hemophilia Foundation, Milwaukee
    Search for more papers by this author
  • Jack Lazerson

    1. Department of Pediatrics, The Medical College of Wisconsin, Milwaukee
    2. Great Lakes Hemophilia Foundation, Milwaukee
    Search for more papers by this author

Abstract

In theory, the potency of cryoprecipitated antihemophilic factor (cryo) can be increased by utilizing plasma only from donors with high levels of factor VIII procoagulant activity (fVIIIc). Previous reports have suggested that plasma of group O individuals has, on the average, less fVIIIc than plasma from individuals of blood groups A, B, and AB. We have investigated the feasibility of increasing the potency of cryo by preselecting plasma for cryo production on the basis of the blood group of the donor. FVIIIc levels of fresh plasma, fresh frozen plasma (FFP), and cryo (prepared both by air-thaw and water-thaw methods) were assayed. The plasma, FFP, and cryo from group O donors contained only 75% of the fVIIIc present in plasma from group A, group B, and group AB donors. Following infusion to patients with hemophilia, in vivo recovery and survival of fVIIIc activity from groups A, B, and AB cryo reflected the higher in vitro levels. The mean potency of bags of cryo can be increased, and the cost of hemophilia treatment with cryo can be reduced by excluding group O plasma from the production of cryoprecipitate.

Ancillary