title: Comparison of different prothrombin complex concentrates--in vitro and in vivo studies.
abstract: The potency and tests for thrombogenicity were studied prospectively in 7 different (two lots of each brand, A-G) prothrombin complex concentrates (PCC). Human albumine (H) and a factor IX concentrate (I), served as controls. The potency of coagulation factors and inhibitors varied considerably. Two brands (E, F) contained no protein S, additionally one brand contained no protein C. Two preparations exhibited high amidolytic activities, especially towards the thrombin-sensitive chromogenic substrate S-2238, in vitro. These activities could be quenched in part by the addition of hirudin or antithrombin III. The heparin and antithrombin III content of the PCCs was significantly different, and, after addition of antithrombin III an increase of thrombin-antithrombin III complexes in 2 preparations (B, D) was observed in vitro. Additionally, three brands (B, D, F) caused more severe cardio-pulmonary reactions in rabbits, associated with an increase of fibrin split products for brands B and D. We conclude that the use of these preparations in patients, in whom an acquired protein C or S defect, or a hypercoagulable state, can be suspected, cannot be recommended.
authors: Department of Clinical Haemostaseology and Transfusion Medicine, University of Saarland, Homburg/Saar, F.R.G.
authors: M
authors: M
authors: Köhler
authors: M
authors: M
authors: Heiden
authors: G
authors: G
authors: Harbauer
authors: C
authors: C
authors: Miyashita
authors: S
authors: S
authors: Mörsdorf
authors: B
authors: B
authors: Braun
authors: P
authors: P
authors: Ernert
authors: E
authors: E
authors: Wenzel
authors: S
authors: S
authors: Rose
authors: G
authors: G
authors: Pindur
mesh_terms: D000818:Animals; D000990:Antithrombin III / Q000032:analysis; D001779:Blood Coagulation Factors / Q000032:analysis / Q000302:isolation & purification* / Q000494:pharmacology; D002863:Chromogenic Compounds; D004151:Dipeptides; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D006023:Glycoproteins / Q000032:analysis; D006439:Hemodynamics / Q000187:drug effects; D006493:Heparin / Q000032:analysis; D006801:Humans; D066298:In Vitro Techniques; D011486:Protein C / Q000032:analysis; D017293:Protein S; D011817:Rabbits; D013917:Thrombin / Q000032:analysis
chemical_list: D001779:Blood Coagulation Factors; D002863:Chromogenic Compounds; D004151:Dipeptides; D005338:Fibrin Fibrinogen Degradation Products; D006023:Glycoproteins; D011486:Protein C; D017293:Protein S; C036309:fibrin fragment D; C025667:prothrombin complex concentrates; C021129:S 2238; D000990:Antithrombin III; D006493:Heparin; D013917:Thrombin