FIBRIN SEALANT - AN EVALUATION OF METHODS OF PRODUCTION AND THE ROLE OF THE BLOOD-BANK

Blood banks can prepare fibrin sealant by several methods. Allogeneic components allow for banking of the fibrinogen concentrate for immedia te use. Autologous components eliminate the risk of transfusion-transm itted disease to the recipient, but not necessarily to the preparer. E thanol and ammonium sulfate precipitation of fibrinogen concentrate al low use of autologous blood and fast preparation (less than 90 minutes ). Cryoprecipitation from liquid plasma is adequate, conserving fresh frozen plasma. Cryoprecipitation by the ''freeze-thaw'' method has bee n reported to have the highest fibrinogen yield (7840 mg/dL +/- 1800 m g/dL), whereas ammonium sulfate precipitation has been reported to hav e the highest bonding strength (41 g/cm(2) 10 minutes after thrombin a ddition). Cost, storage, preparation time, and transfusion-transmitted disease all play a role in choice of method.