Thawed cryoprecipitate stored for 6 h at room temperature: a potential alternative to factor VIII concentrate for continuous infusion.
Continuous infusion (CI) of factor VIII concentrates has been demonstrated to be cost-effective method in maintaining stable levels of FVIII activity in haemophilia A patients with major bleeding or undergoing major surgery. Cryoprecipitates remain the major source of FVIII in developing countries-like the Philippines because of limited availability and high cost of concentrates. To support the use of cryoprecipitate as alternative to FVIII concentrate for CI in centres with no factor concentrates, FVIII levels in 37 bags of random cryoprecipitate were measured at 0, 2, 4 and 6 h after thawing, kept at room temperature with bacteriological culture studies performed on the sixth hour. The mean FVIII content at hour 0 was 108.10 U per bag. Type ORh+ blood had lower FVIII content (+/-78.91 U per bag) compared with blood types ARh+ (+/-121.64 U per bag) and BRh+ (+/-117.04 U per bag). The units stored <6 months had higher FVIII content (+/-117.74 U per bag) compared with those stored for over 6- but <12-months (+/-66.77 U per bag). The mean rate of decline of FVIII activity at 2, 4 and 6 h was statistically significant at 10.35% (P = 0.000), 21.49% (P = 0.000) and 29.41% (P = 0.000) from baseline, respectively, using the paired t-test. Similar finding was found across different blood types and storage duration. Only one of 37 bags grew Staphylococcus aureus on day 10 of incubation.
Pesquera-Lepatan
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Section of Pediatric Hematology-Oncology and the Hemophilia Center, University of Santo Tomas Hospital, Manila, Philippines. maetext@yahoo.com
Hernandez
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Lim
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Chua
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D015925:Cryopreservation; D005169:Factor VIII / Q000008:administration & dosage*; D006467:Hemophilia A / Q000628:therapy*; D006801:Humans; D007262:Infusions, Intravenous
D005169:Factor VIII