Hemostatic profile and safety of pooled cryoprecipitate on extended storage after thawing

BACKGROUND: Cryoprecipitate, rich in fibrinogen, factor VIII (FVIII), and von Willebrand factor (VWF), is used to manage bleeding in trauma and coagulopathy. Current guidelines require cryoprecipitate to be transfused within 4–6 h of thawing, limiting availability in emergency situations and increasing wastage. This study assesses the stability of coagulation factors and sterility in thawed cryoprecipitate stored at room temperature (20°C–24°C) for up to 5 days. METHODS: This prospective observational study was conducted at a tertiary care hospital. Cryoprecipitate was prepared from fresh frozen plasma stored at −80°C and pooled into 10 units (four from blood groups A and B and two from blood group O). Samples were analyzed on days 0, 3, and 5 postthawing for fibrinogen activity, FVIII, and VWF activity levels. Sterility was evaluated using the BacT/Alert system at 0 and 120 h. Statistical analyses included paired t -tests and ANOVA. RESULTS: There was no significant decrease in fibrinogen levels (mg/unit) between day 0 (250.5 ± 25.8) and day 3 (238.34 ± 29.61, P = 0.07) and to day 5 (226.51 ± 28.39, P = 0.62), all units maintained above the 150 mg/unit threshold. Similarly, there was no significant reduction in VWF levels (IU/unit) as well, between day 0 (218.50 ± 45.56) to day 3 (201.84 ± 41.91, P = 0.06) and to day 5 (180.62 ± 38.77, P = 0.13). However, FVIII activity significantly declined by 21.88 IU/unit from 113.70 ± 20.91 IU/unit to 91.82 ± 16.36 IU/unit, P = 0.001 from day 0 to day 3 and also declined by 9.57 IU/unit to 82.25 ± 14.91, P = 0.001 from day 3 to day 5 with only 60% of units maintaining ≥80 IU/unit. Sterility was maintained with no bacterial growth observed. CONCLUSIONS: Thawed cryoprecipitate can retain adequate fibrinogen and VWF levels for up to 5 days, although FVIII declines significantly, particularly in group O pools. Extended storage at room temperature may reduce wastage and improve availability in emergencies, particularly as a source of fibrinogen.