(P-TS-75) Pathogen Reduced Cryoprecipitate Implementation and Assessment of Its Impact in a Large Academic Medical System

Cryoprecipitate anti-hemophilic factor (AHF), also known as cryoprecipitate, is a blood product prepared from Fresh Frozen Plasma (FFP) by precipitation and is enriched for fibrinogen, von Willebrand Factor (vWF), factor VIII, factor XIII, and fibronectin. AHF is thawed on demand and once thawed expires after storage 4-6 hours at 20-24ºC. INTERCEPT fibrinogen concentrate (IFC) is approved by the Food and Drug Administration (FDA) and contains fibrinogen, factor XIII and vWF, has similar clinical indications as cryoprecipitate. IFC has a shelf life of 5 day after thawing. The goal of this study is to evaluate effect of IFC implementation on turnaround time (TAT) and product wastage compared to cryoprecipitate at a large academic medical center.

Study

Design/Methods: Prior to implementation, six units of thawed IFC was stored at 20-24°C at any given time, order set modifications were made and staff was education. FC15 was selected because a pooled dose of 4 units (contains average of 1457 mg fibrinogen) can be used interchangeably with pooled doses of 5 cryoprecipitate units (contains average of 1800 ± 330 mg), allowing for flexibility in inventory if needed. IFC became available to clinicians on April 18, 2024. A retrospective review of TAT for cryoprecipitate was performed for orders from operating rooms from 1/1/2023 to 12/31/2023, and for wastage from 1/2/2022 to 12/31/2023. TAT is defined as the time from when AHF or IFC is ordered until ready for issue in blood bank. Data on TAT and wastage was collected for IFC from 4/18/24 to 5/13/2024.

Results/Findings:

The total of 997 AHF and 97 IFC orders were included. Mean TAT for cryoprecipitate was 44.7 minutes (range 35-82.2 minutes) and for IFC was 12.2 minutes (range 2.2.-25.4 minutes). Cryoprecipitate wastage rate was 16 of 1677 units (0.6%) for 2022 and 3 of 2663 units (0.1%) for 2023. No IFC products were wasted for the given period of time (0 of 181 units wasted for the study period).

Conclusions:

IFC decreases TAT by 3-fold compared to AHF which may improve situations that require rapid use (e.g. massive transfusions or cardiac surgeries). Although wastage is low for AHF at our institution during the time frames studied, it was reduced to zero using IFC. A future study will determine if shorter TATs, lower wastage, and inventory are sustained over time, and the overall cost effectiveness of the product change.