McLeod B C, Sassetti R J, Cole E R, Scott J P
Ann Intern Med. 1987 Jan;106(1):35-40. doi: 10.7326/0003-4819-106-1-35.
Current factor VIII products expose recipients to many donors and hence to a high risk of acquiring blood-borne infections. Plasma-exchange donation of cryoprecipitate can reduce donor exposure by repeatedly obtaining large yields of factor VIII from individual donors. In this study, donor factor VIII levels were stimulated with desmopressin before donation. Mean yield per donation increased from 1399 +/- 425 IU in controls to 3818 +/- 1350 IU in stimulated donations (p less than 0.001), and mean factor VIII concentration in the cryoprecipitate increased from 8.2 +/- 3 IU/mL to 24 +/- 12 IU/mL (p less than 0.001). A new packaging system dispenses assayed aliquots of stimulated cryoprecipitate in plastic vials. The direct cost of production for this material is $.065 per unit. The cryoprecipitate is hemostatically active and convenient to use, and the aggregate yields from sequential donations by stimulated persons are high enough to allow long-term, single-donor support of many adults with hemophilia.
目前的凝血因子VIII产品使接受者接触众多供体，因此感染血源性疾病的风险很高。通过血浆置换捐献冷沉淀，可从个体供体反复大量获取凝血因子VIII，从而减少对供体的接触。在本研究中，捐献前用去氨加压素刺激供体的凝血因子VIII水平。每次捐献的平均产量从对照组的1399±425国际单位增加到刺激捐献组的3818±1350国际单位（p<0.001），冷沉淀中的平均凝血因子VIII浓度从8.2±3国际单位/毫升增加到24±12国际单位/毫升（p<0.001）。一种新的包装系统将经检测的刺激冷沉淀分装到塑料瓶中。这种材料的直接生产成本为每单位0.065美元。冷沉淀具有止血活性且使用方便，刺激后的个体连续捐献的总产量足以长期为许多成年血友病患者提供单供体支持。
