Q: 43 year old female is transferred to ICU with diagnosis of thrombocytopenic purpura (TTP). Looking at previous record you found 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 the cryoprecipitate has been removed. The resulting plasma has reduced levels of Factor VIII, von Willebrand factor, Factor XIII, fibronectin and fibrinogen.

Cryo-poor plasma is used for the treatment of relapsing TTP for which regular plasma exchange is not effective. 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, requiring advance notice.