title: Approaches to plasma fractionation for improved recovery and the development of potentially useful clinical factors.
abstract: World-wide use of large amounts of highly purified Factor VIII and Factor IX concentrates has increased steadily over the last decade. The increase has resulted in more effective treatment of patients with haemophilia, especially those patients on home care and 'demand' therapy, those on prophylactic therapy for chronic bleeding or those on maintenance therapy for the suppression of inhibitors. Changing socioeconomic conditions have also contributed to greater use of the concentrates. The trend is putting an increasing strain on conventional methods for collecting and fractionating plasma. These include the donor, the nature of the anticoagulant, methods for purification of the clotting factors, procedures for denaturation and/or separation of viral contaminants and patterns of clinical usage. As a result, it is essential that we upgrade the quantity and quality of plasma collected and utilize the most effective new methods for increasing the yield and purity of the plasma fractions. Of special significance are recently described procedures for heat inactivation and/or separation of viral contaminants from the fractions and the long-term promise of genetically engineered proteins.
mesh_terms: D000917:Antibody Formation; D001779:Blood Coagulation Factors / Q000302:isolation & purification* / Q000627:therapeutic use; D001800:Blood Specimen Collection / Q000379:methods; D001803:Blood Transfusion / Q000379:methods*; D005591:Chemical Fractionation / Q000379:methods; D004274:DNA, Recombinant / Q000627:therapeutic use; D005164:Factor IX / Q000627:therapeutic use; D015949:Factor IXa; D005169:Factor VIII / Q000276:immunology / Q000302:isolation & purification / Q000627:therapeutic use; D005340:Fibrinogen / Q000302:isolation & purification; D006467:Hemophilia A / Q000628:therapy*; D006525:Hepatitis, Viral, Human / Q000209:etiology; D006801:Humans; D010949:Plasma / Q000032:analysis*; D065227:Transfusion Reaction
chemical_list: D001779:Blood Coagulation Factors; D004274:DNA, Recombinant; C026912:cryoprecipitate coagulum; D005169:Factor VIII; D005164:Factor IX; D005340:Fibrinogen; D015949:Factor IXa