Comparison of coagulation factor XIII content and concentration in cryoprecipitate and fresh-frozen plasma.
BACKGROUND
For patients with plasma coagulation factor XIII (pFXIII) deficiency, recommended means of replacement include infusions of fresh-frozen plasma (FFP), cryoprecipitate, or (where available) factor (F)XIII concentrates. Quantitative differences in pFXIII concentration in FFP and cryoprecipitate are not well defined and were, therefore, the subject of this study.


METHODS
FFP and cryoprecipitate (10 bags each from blood group O donors) were analyzed to quantify pFXIII activity and antigen. Coagulation FVIII, fibrinogen, and von Willebrand factor (VWF) were also quantitated.


RESULTS
Mean (+/-SD) pFXIII activity in cryoprecipitate and FFP bags was 60 +/- 30 and 288 +/- 77 U per bag, respectively, and pFXIII antigen and activity levels were concordant. Other comparisons (mean +/- SD) between cryoprecipitate and FFP, respectively, were as follows: coagulation FVIII activity, 133 +/- 37 and 265 +/- 83 U per bag; fibrinogen content (Clauss kinetic assay), 183 +/- 44 and 725 +/- 199 mg per bag; VWF antigen content, 181 +/- 53 and 218 +/- 70 U per bag; VWF ristocetin cofactor activity, 168 +/- 34 and 221 +/- 65 U per bag; VWF collagen-binding activity, 164 +/- 40 and 208 +/- 71 U per bag; and fluid (plasma) volumes per bag, 21.3 +/- 2.7 and 245 +/- 29 mL.


CONCLUSIONS
In contrast to other cryoprecipitable coagulation proteins, pFXIII is only mildly enriched in cryoprecipitate when compared with FFP (approx. two- to threefold). Although both products can provide effective pFXIII replacement, FFP may be preferred when infusion volume is not a major consideration and pFXIII concentrates are not available. VWF is substantially enriched in cryoprecipitate (approx. ninefold compared with its concentration in FFP), with VWF activity content exceeding that of FVIII by approximately 26 percent on average.
Caudill
Jonathan S C
JS
Divisions of Pediatric Hematology/Oncology, Hematology, Hematopathology, and Transfusion Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Nichols
William L
WL
Plumhoff
Elizabeth A
EA
Schulte
Sandra L
SL
Winters
Jeffrey L
JL
Gastineau
Dennis A
DA
Rodriguez
Vilmarie
V
D001793:Blood Preservation / Q000379:methods; D005169:Factor VIII / Q000737:chemistry*; D005176:Factor XIII / Q000032:analysis* / Q000276:immunology / Q000378:metabolism; D005340:Fibrinogen / Q000032:analysis / Q000737:chemistry*; D006801:Humans; D009994:Osmolar Concentration; D010949:Plasma / Q000737:chemistry*; D014841:von Willebrand Factor / Q000032:analysis
C026912:cryoprecipitate coagulum; D014841:von Willebrand Factor; D005169:Factor VIII; D005340:Fibrinogen; D005176:Factor XIII