[Formation of cryoprecipitate in the blood bag].
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Biomedical subjects
Publications and source records attributed to K H Uteg.
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By referring initially to remarks about the structure and function of the coagulation factor VIII and about the manufacture and demand for preparations for the substitution treatment in patients affected with haemophilia A, possibilities are presented how to increase the collection of factor VIII by applying intensive measures. These involve the impact on the basic material (including donors) as well as process variables within the range of plasma collection and process technique. On the basis of own research results and data from literature the following measures can be introduced and evaluated as far as their effect on the collection of factor VIII is concerned: Donor testing, selection: increased by 25% approximately Plasmapheresis, blood bags: (prerequisite for certain technological measures) Thawing technique: increase by 20-30% approximately (thaw siphon) Citrate-free anticoagulant: increase by 30% approximately (e.g. heparin) Donor conditioning: increased by 200-400% approximately (DDAVP) The establishment of possible and reasonable combinations of measures can contribute to intensify the collection of factor VIII. The advantages to be expected are mentioned. The level of gene-technological collection of factor VIII is dealt with prospectively.
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For the purpose of establishing a programme of plasmapheresis for manufacturing preparations containing factor VIII, investigations were made to check the expediency of selecting donors. Factor VIII activity (Factor VIII: C) was determined in a total of 165 donors of plasmapheresis. Dependencies of factor-VIII: C on blood group, age and influence of smoking were examined. Depending on the blood group (0 less than A, B, AB) the results found by us showed significant differences in factor-VIII: C. The results are discussed and compared with data in literature. A selection of donors is considered to be reasonable. Increases in gaining factor-VIII are possible by making a pre-selection according to blood groups or better by exact testing respectively.
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The total proteins are enriched 2.41 fold by cryoprecipitation. The protein fractions, however, have the same distribution as in the original plasma. With the help of radial immunodiffusion method haptoglobins were measured to have enriched to 351%, IgG to 252%, IgA to 307%, and IgM to 268%. The simultaneous increase of functional properties was systematically observed by taking the complete ABO-isoagglutinin titre as an example. The titre increase moves within the range of 1 to 2 degrees.
By measuring the osmolality of plasma and the cryoprecipitate gained by it as well as by measurements of conductivity the previously reported observations about the enrichment of electrolytes in cryoprecipitates could be confirmed. The findings show that these preparations represent hyperosmolic solutions. This fact should by kept in mind when applying them.
18 sera of haemophilia-A patients were examined for the presence of antithrombocytic and antileukocytic antibodies. It was only in a very small number of test persons (5) that antibodies could be found, though a variety of cryoprecipitate transfusions had preceded. The causes are discusses. The correlation existing between the presence of antibodies and the appearance of transfusion reactions is refferred to.
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