Advances in plasmatic fractions used in blood transfusion.

I tried to give a bird's eye view of some of the intriguing recent advances in the production and clinical use of albumin, immunoglobulins, coagulation factors, protease inhibitors and plasma enzyme preparations. I aimed to put into the limelight of my lecture the basic differences between the reaction of plasma proteins in solutions in the test tube or on model surfaces in vitro as opposed to the well-balanced intricate protein-protein and cell membrane-plasma protein interactions in vivo. In the light of these recent advances we have to reassess the biological properties, structural and functional integrity of our plasma protein preparations. In spite of technical and regulatory difficulties new fractionation techniques have to break through. Especially gentle techniques which do not denature proteins are badly needed. Purified albumin with an adequate fatty acid content seems to be the safest and therapeutically most useful preparation among the albumin containing fractions. PPF and even albumin are, however, not so safe as we have thought. There is an urgent need to fight more intensively against their unjustified use. There is a growing need for specific immunoglobulins, coagulation factors, protease inhibitors and therapeutically useful enzyme preparations.