Use of cryoprecipitate coagulum in extracting renal calculi

Human cryoprecipitated plasma can form an extractable coagulum which will effectively remove renal calculi in selected cases. We successfully used this blood product and a simplified injection technique in 30 patients undergoing surgery for upper tract calculi. Coagulum pyelolithotomy was performed in 24 cases with removal of all stones in 23 (96 per cent). In 6 patients incomplete stone removal by conventional operative methods was successfully completed by using the coagulum as an adjunctive procedure. In 10 of the 30 cases (33 per cent) radiographically "silent" calculi were recovered within the cryoprecipitate clot. The advantages of cryoprecipitate over previously reported blood products, certain technical simplifications, and the appropriate clinical indications for the coagulum procedure are discussed.