A number of hemophiliacs, particularly on self infusion programs, avoid the use of a filtration apparatus when transfusing cryoprecipitate because it is thought Factor VIII activity is decreased, ;and it makes the procedure too cumbersome. The purpose of this study was to document that no loss of Factor VIII occurred using conventional filtration, and that blood filters are necessary. Individual and pooled units of cryoprecipitate were passed through standard blood administration sets, cryoprecipitate sets and 40 micron ultrafiltration sets. Factor VIII levels were performed on pre and post transfusion samples. The used filters were examined using conventional light, scanning (SEM), and transmission electron microscopy (TEM). No decrease in Factor VIII (p <.001) was noted when pre versus post filtration assays were compared. Examination of the filters by light microscopy demonstrated a greater than 50% obstruction of the available filter area in 39/60 units examined, and this material appeared to contain fibrin. This was substantiated by SEM and TEM examination which identified the fibrillar structure of fibrin on all filters. Furthermore, the deposits were contaminated by globular and flocculent proteinaceous material, accompanied by cellulose and plastic debris. This material passed through conventional filters, but was successfully removed by a graded 40 micron filter. This study not only demonstrates the necessity for careful filtration of cryoprecipitate prior to administration, but also identifies significant contaminating materials.
Blood Filters in Children with
COVID
‐19 and
AKI
: A Review
