Asian Journal of Transfusion Science
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LETTER TO THE EDITOR Table of Contents   
Year : 2017  |  Volume : 11  |  Issue : 2  |  Page : 215-216
Hello…. there is a blob of quark in my cryo bag!!


1 Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
2 Department of Transfusion Medicine, T.S. Misra Medical College and Hospital, Lucknow, Uttar Pradesh, India

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Date of Web Publication11-Sep-2017
 

How to cite this article:
Sonker A, Dubey A, Chaudhary R. Hello…. there is a blob of quark in my cryo bag!!. Asian J Transfus Sci 2017;11:215-6

How to cite this URL:
Sonker A, Dubey A, Chaudhary R. Hello…. there is a blob of quark in my cryo bag!!. Asian J Transfus Sci [serial online] 2017 [cited 2017 Nov 20];11:215-6. Available from: http://www.ajts.org/text.asp?2017/11/2/215/214351


Sir,

Cryoprecipitate (cryoprecipitated antihemophilic factor, cryo) is produced when the cold-insoluble glycoproteins precipitate in fresh frozen plasma thawed between 1°C and 6°C. After precipitation, it is centrifuged and supernatant fluid is removed. The remnant plasma (approximately 15 ml) is refrozen and stored at −18°C or below. Before its administration, cryoprecipitate is thawed in a circulating water bath at 30–37°C for approximately 10–15 min. The thawed precipitate is resuspended in residual plasma either by kneading or by adding normal saline.[1] Once thawed, cryoprecipitate should not be refrozen and should be kept at temperatures of 20–24°C for no longer than 6 h to preserve the activity of the coagulation proteins.[2]

Six units of cryoprecipitate were issued from our blood bank to a patient of liver cirrhosis by a night duty technologist. The units were not thawed as the water bath in the blood bank was non-functional due to some technical fault. Plastic overwraps were issued along with the units and the nurse in-charge was asked to thaw the units using the water bath designated for the wards. After 1 h, the consultant on duty received a panic call from the ward nurse that there is a mass of cheesy material in the cryo bags. The bags were called back to the blood bank. On inspection, we found that there was precipitation of cryo-proteins in the bags which have formed a firm white mass [Figure 1]. On investigation, it was divulged that a newly recruited nurse has been given the night duty charge. She was not adequately informed about the procedure for thawing the cryo during the shift change. She placed the bags with over-wraps under running water. The water was chilling as it was a winter month, which led to cryoprecipitation.
Figure 1: Image of cryo bag showing cryoprecipitated proteins as a white mass

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Subsequently, new cryo bags were issued for the patient and were thawed at recommended temperature in the ward side water bath before transfusion. This case underscores the need for continued education of ordering physicians and nurses on the appropriate bedside handling of the precious blood components.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Brecher ME, editor. Technical Manual. 15th ed. Bethesda, MD: American Association of Blood Banks; 2005.  Back to cited text no. 1
    
2.
O'Shaughnessy DF, Atterbury C, Bolton Maggs P, Murphy M, Thomas D, Yates S, et al. Guidelines for the use of fresh-frozen plasma, cryoprecipitate and cryosupernatant. Br J Haematol 2004;126:11-28.  Back to cited text no. 2
    

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Correspondence Address:
Anju Dubey
Department of Transfusion Medicine, T.S. Misra Medical College and Hospital, Lucknow, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-6247.214351

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2006 - Asian Journal of Transfusion Science | Published by Wolters Kluwer - Medknow
Online since 10th November, 2006