Cryoprecipitate Transfusion and Clinical Outcomes After Adult Cardiac Surgery: A Meta-Analysis

Background: Cryoprecipitate is frequently administered to patients undergoing cardiac surgery; however, evidence regarding its safety and clinical effectiveness remains limited and inconclusive. Methods: We systematically searched PubMed, Embase, Scopus, and the Cochrane Library to identify randomized controlled trials and observational studies comparing cryoprecipitate transfusion versus no cryoprecipitate in adult patients undergoing cardiac surgery. The primary outcome was all-cause mortality. Secondary outcomes included infection and acute kidney injury (AKI). Pooled odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated using a random-effects model, and statistical heterogeneity was assessed using the I 2 statistic. Results: Three observational studies comprising 19,430 patients were included. Of these, 9,441 patients (40.6%) received cryoprecipitate, while 9,989 patients (59.4%) did not. The mean age across studies was 66.2 years, and 31% of patients were female. Cryoprecipitate transfusion was not associated with a significant difference in mortality (OR = 0.95; 95% CI, 0.55-1.63; I 2 = 65%; p = 0.84) or AKI (OR = 0.98; 95% CI, 0.66-1.45; I 2 = 82%; p = 0.93). However, cryoprecipitate use was associated with a significant reduction in postoperative infection (OR = 0.75; 95% CI, 0.69-0.83; I 2 = 0%; p < 0.00001). Conclusions: In this meta-analysis of observational studies, cryoprecipitate transfusion following adult cardiac surgery was associated with a lower risk of postoperative infection, but showed no significant effect on mortality or acute kidney injury. Larger prospective studies are warranted to further clarify the clinical impact of cryoprecipitate use in cardiac surgery.