Korean J Blood Transfus.  1996 Dec;7(2):187-195.

Cryosuperna. tant for the Therapeutic Plasma Exchange in Hemolytic Uremlc Syndrome: The Characteristics of Home-made Cryosupernatant

• Kim SH
• Kim DW
• Lee WI
• Ryu KH
• Ki CS
• Oh HY

Abstract

Cryosupernatant which is the residual plasma fraction after removing cryoprecipitate has been used for plasma exchange in thrombotic thrombocytopenic purpura and hemolytic uremic syndrome replacing the fresh frozen plasma. Recently, the unusually large yon Willebrand factor multireefs (ULvWFM) has been observed in patients with refractory or chronic relapsing hemolytic uremic syndrome as well as thrombotic thrombocytopenic purpura which disappeared by infusion or plasma exchange with cryosupernatant, and infusion of fresh frozen plasma, the largest multimers of yon Willebrand factor were replenished that it might be a cause of refractoriness. This study was conducted to investigate the characteristics of home-made cryosupernatant from thawed fresh frozen plasma and its thehrapeutic effect in a hemolytic uremic syndrome patient. The level of fibrinogen, coagulation factor VIII, vWF antigen, and ristocetin cofactor activity was decreased and yon Willebrand factor multimers were barely seen in cryosupernatant than those of in fresh frozen plasma. A hemolytic uremic syndrome patient tried with exchange and infusion of cryosupernatant showed excellent recovery. It is concluded that home-made cryosupernatant shares many of the features of fresh frozen plasma except factor VIII, especially von Willebrand factor multimers, and thus it could be a useful alternative to fresh frozen plasma in case of refractory hemolytic uremic synydrome.

MeSH Terms

Factor VIII
Fibrinogen
Hemolytic-Uremic Syndrome
Humans
Plasma Exchange*
Plasma*
Purpura, Thrombotic Thrombocytopenic
von Willebrand Factor
Factor VIII
Fibrinogen
von Willebrand Factor