• Skip to main content
  • Skip to primary sidebar
Transfusion News
  • About Us
  • Topics
    • Adverse Events (non-infectious)
    • Blood Donation
    • Cell Therapy
    • Coagulation & Plasma Transfusion
    • Platelet Transfusion
    • Policy and Guidelines
    • Quality Control and Regulatory
    • RBC Transfusion
    • Serology/Genotyping
    • Special Transfusion Situations
    • Transfusion Transmitted Infections
  • Continuing Education
  • Archives
  • Podcasts
  • Question of the Day
  • Search
  • Subscribe to Email Alerts
  • Follow us on
  • Search
  • Subscribe to Email Alerts

Fibrinogen Concentrate Is Equivalent to Cryoprecipitate for Bleeding after Cardiac Surgery

October 23, 2019

Guidelines for the treatment of bleeding due to hypofibrinogenemia (fibrinogen level <1.5-2.0 g/L) after cardiac surgery recommend using either cryoprecipitate or fibrinogen concentrate, but comparative data for the two treatment strategies is lacking. As reported this week at the AABB 2019 Annual Meeting and published in JAMA, the FIBRES randomized non-inferiority clinical trial compared these two products at 11 Canadian hospitals. From February 2017 to November 2018, 735 patients undergoing cardiac surgery with hypofibrinogenemia related bleeding post-surgery were randomized 1:1 to receive either fibrinogen concentrate (N=372, 4 g) or cryoprecipitate (N=362, 10 units). A mean of 16.3 (95% CI, 14.9 to 17.8) units of allogenic blood derived products (red blood cells, platelets, and plasma) were transfused in the 24 hours post-surgery in the fibrinogen concentrate group compared to 17.0 (95% CI, 15.6-18.6) units in the cryoprecipitate group (P<0.001 for non-inferiority; P=0.50 for superiority). Non-inferiority for fibrinogen concentrate was also reported for cumulated allogenic blood components transfused 7 days post-surgery, and adverse events were similar in both groups. Further research and considerations on fibrinogen concentrate vs. cryoprecipitate should focus on other patients with hypofibrinogenemia, cost, and the risk of transfusion-transmitted infections.

References:

  1. Callum J, Farkouh ME, Scales DC, Heddle NM, et al. Effect of fibrinogen concentrate vs cryoprecipitate on blood component transfusion after cardiac surgery: the FIBRES randomized clinical trial. JAMA 2019; doi:10.1001/jama.2019.17312
  2. Callum J, Farkouh ME, Scales DC, Heddle NM, et al. Abstract PL1-MN4-32: The FIBRES randomized controlled noninferiority trial of fibrinogen concentrates versus cryoprecipitate in cardiac surgery: subgroup and safety analysis. Presented at AABB Annual Meeting; 2019 Oct 19-22; San Antonio, TX.

Filed Under

  • Coagulation & Plasma Transfusion
  • News
  • Special Transfusion Situations

Recommended

  • Higher Donor Body Mass Index is Associated with Increased RBC Hemolysis

  • Transfusion of Older Red Blood Cells Do Not Effect Long Term Survival of Cardiac Surgery Patients

  • Tranexamic Acid Reduces Risk of Death in Patients with Traumatic Brain Injury

Show Comments

Comments on this article are closed.

Get the latest news. Subscribe to our mailing list. Sign Up

Primary Sidebar

Latest News

  • Acute Normovolemic Hemodilution Does Not Reduce RBC Transfusions

  • Blood Donation Teams—a Novel Strategy to Support Novice Donors

  • Plasma Exchange to Reduce Biological Age

  • New Guidelines for Platelet Transfusion Recommend Restrictive Strategies

    Question of the Day

    Copyright © 2025 John Wiley & Sons, Inc. All Rights Reserved.
    Privacy Policy

    Association for the Advancement of Blood and Biotherapies Wiley