Treatment of thrombotic thrombocytopenic purpura with the cryosupernatant fraction of plasma: a case report and review of the literature.

We report a case of thrombotic thrombocytopenic purpura (TTP) that did not respond to extensive plasma exchange with fresh frozen plasma (FFP) but responded to plasma exchange with cryosupernatant. Several reports indicate that responses to cryosupernatant may be seen in patients refractory to FFP, and this approach may be appropriate in these patients before one recommends a splenectomy. The literature on refractory TTP treated with cryosupernatant exchange is reviewed.