Cryo-poor plasma

Q: 43 year old female is transferred to ICU with diagnosis of thrombocytopenic purpura (TTP). Looking at previous records, you found a similar episode 4 years ago. It is mentioned that patient didn't respond to regular plasma exchange and required cryo-poor plasma exchange. What is cryo-poor plasma? 

 Answer: Cryo-poor plasma or cryosupernatant refers to plasma from which cryoprecipitate has been removed. The resulting plasma has reduced Factor VIII, von Willebrand factor, Factor XIII, fibronectin, and fibrinogen levels. Cryo-poor plasma may treat relapsing TTP, for which regular plasma exchange is ineffective. 

The rationale for using cryo-poor plasma in these refractory patients is that no additional von Willebrand factor will be administered to these patients who already have too much von Willebrand factor activity due to the presence of extra-large multimers of vWf. Caution: It is not a component regularly stocked in the blood bank. Usually, it will require special preparation and advance notice.

 

#hematology 

 Reference: 

Marcela P. Mafra, Maria Meritxell Roca Mora, Amanda Godoi, Andres Valenzuela - Cryoprecipitate-Poor Plasma Instead of Fresh Frozen Plasma As Replacement Therapy in Thrombotic Thrombocytopenic Purpura: A Systematic Review and Meta-Analysis - Blood (2023) 142 (Supplement 1): 2629.- https://doi.org/10.1182/blood-2023-188500