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Fractionation of Factor VIII and IX ‐ An Overview
Author(s) -
Johnson A.J.,
Mathews R.W.,
Fulton A.J.
Publication year - 1984
Publication title -
scandinavian journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0036-553X
DOI - 10.1111/j.1600-0609.1984.tb02611.x
Subject(s) - fractionation , potency , factor ix , medicine , coagulation , hepatitis b , hepatitis b virus , chemistry , virus , immunology , chromatography , biochemistry , in vitro
The recent development of concentrated plasma fractions for the treatment of Hemophilia A (factor VIII:C) and Hemophilia B (factor IX) has greatly facilitated replacement therapy in patients with congenital deficiencies of these components and has proven essential for home therapy with normalization of the patients' life style. Preparation of the concentrates requires adequate amounts of high quality plasma frozen promptly to preserve the activity of the coagulation factors. In a large, regional blood center in the U.S. the average potency of the fresh‐frozen, single‐donor plasma averaged about 1.0 U/ml over a period of four years. The effectiveness, cost, incidence of reactions and potential for transmission of hepatitis vary with the purity and yield of the concentrates, and possibly the size of the initial plasma pool from which the concentrate is derived. The higher the purity, the greater the solubility, concentration and convenience, and the lower the potential toxic effects, including possible contaminating viruses. The higher the yield, the lower the cost to the producer and consumer. The larger the starting pool of plasma, the greater the likelihood of contamination with hepatitis virus or (possibly) acquired immune deficiency syndrome (AIDS). The comparative advantages and disadvantages of the various fractionation methods are explored together with the areas of optimal usefulness, including hemophilia A and hemophilia B with and without endogenous inhibitors. Some attention is also given to the comparative freedom of most concentrates from contamination by hepatitis B, non‐A, non‐B, and possibly AIDS.