Conventional replacement
therapy for hypofibrinogenemia and
von Willebrand's disease requires multiple donor exposures and a correspondingly high risk of
blood-borne infection. We describe the collection and successful use of cryoprecipitate derived from a single donor by
plasma exchange donation to support such patients through major
hemostatic stresses. The father of an epileptic patient with
von Willebrand's disease produced cryoprecipitate containing 23,546 units of
von Willebrand factor (vWF) in nine
desmopressin-stimulated donations; this provided total factor replacement for neurosurgery to remove a seizure focus. The average yield was 2,616 units per donation and the average VWF concentration in cryoprecipitate was 17.7 units/ml. The husband of a hypofibrinogenemic patient with a history of
postpartum hemorrhage provided cryoprecipitate containing 13.4 g of
fibrinogen in five donations; this supported his wife through parturition without recourse to other blood products. The average yield was 2.7 g per donation, and the average
fibrinogen concentration was 15.3 g/liter.
Plasma exchange donation is a practical alternative source for cryoprecipitate. It can provide vWF and
fibrinogen that carry a reduced risk of infectious disease transmission.