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).”

Decades ago, researchers discovered that 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 the plasma is the product we now know as “cryoprecipitate” (CRYO), a product rich in coagulation Factor VIII (FVIII) and fibrinogen, among other things.

So, making cryo is great, but what to do with the remainder of the plasma (the part that didn’t precipitate)? Turns out the “leftover” plasma can be refrozen (within 24 hours) and re-labeled as “Plasma, Cryoprecipitate-Reduced.” This product is of course deficient in the factors contained in CRYO, including the two proteins above, as well as von Willebrand Factor (vWF). There isn’t a lot of clinical use for such a product, because of the missing factors. But, once we discovered that the larger multimers of vWF are not well-preserved in this product, and that the von Willebrand factor cleaving enzyme known as ADAMTS13 is quite well preserved in CRP, a possible use became clear. The only real indication for the use of this CRP 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, studies to date have not shown CRP to be substantially more effective that FFP or PF24 for treating TTP.

Since any actual use of CRP, even in TTP, is uncommon, most units of this product are sent for manufacture into therapeutic products used to treat various diseases.

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