Plasma Fractionation and Blood Transfusion: Proceedings of the Ninth Annual Symposium on Blood Transfusion, Groningen, 1984, organized by the Red Cross Blood Bank Groningen-Drenthe

238 Pages·1985·6.18 MB·English

by  F. Peetoom

PLASMA FRACTIONATION AND BLOOD TRANSFUSION
DEVELOPMENTS IN HEMATOLOGY AND IMMUNOLOGY
Lijnen, H.R., Collen, D. and Verstraete, M., eds: Synthetic Substrates in Clinical Blood
Coagulation Assays. 1980. ISBN 90-247-2409-0
Smit Sibinga, C.Th., Das, P.C. and Forfar, J.O., eds: Paediatrics and Blood Transfusion.
1982. ISBN 90-247-2619-0
Fabris, N., ed: Immunology and Ageing. 1982. ISBN 90-247-2640-9
Homstra, G.: Dietary Fats, Prostanoids and Arterial Thrombosis. 1982.
ISBN 90-247-2667-0
Smit Sibinga, C.Th., Das, P.C. and Loghem, van J.J., eds: Blood Transfusion and Prob
lems of Bleeding. 1982. ISBN 90-247-3058-9
Dormandy, J., ed: Red Cell Deformability and Filterability. 1983. ISBN 0-89838-578-4
Smit Sibinga, C.Th., Das, P .C. and Taswell, H.F., eds: Quality Assurance in Blood Bank
ing and Its Clinical Impact. 1984. ISBN 0-89838-618-7
Besseiaar, A.M.H.P. van den, Gralnick, H.R. and Lewis, S.M., eds: Thromboplastin
Calibration and Oral Anticoagulant Control. 1984. ISBN 0-89838-637-3
Fondu, P. and Thijs, 0., eds: Haemostatic Failure in Liver Disease. 1984.
ISBN 0-89838-640-3
Smit Sibinga, C.Th., Das, P.C. and Opelz, G., eds: Transplantation and Blood Transfu
sion. 1984. ISBN 0-89838-686-1
Schmid-Sch6nbein, H., Wurzinger, L.J. and Zimmerman, R.E., eds: Enzyme Activation
in Blood-Perfused Artificial Organs. 1985. ISBN 0-89838-704-3
Dormandy, J., ed: Blood Filtration and Blood Cell Deformability. 1985.
ISBN 0-89838-714-0
Smit Sibinga, C.Th., Das, P.C. and Seidl, S., eds: Plasma Fractionation and Blood
Transfusion. 1985. ISBN 0-89838-761-2
Plasma Fractionation and Blood
Transfusion
Proceedings of the Ninth Annual Symposium on Blood Transfusion, Groningen,
1984, organized by the Red Cross Blood Bank Groningen-Drenthe
edited by
C.Th. SMIT SIBINGA and P.C. DAS
Red Cross Blood Bank Groningen-Drenthe
The Netherlands
S. SEIDL
Red Cross Blood Transfusion Service Hessen
Frankfurt am Main
F.R.G.
1985 MARTINUS NIJHOFF PUBLISHERS •
II
a member of the KLUWER ACADEMIC PUBLISHERS GROUP
BOSTON I DORDRECHT I LANCASTER •
Distributors
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Street, Hingham, MA 02043, USA
jar the UK and Ireland: Kluwer Academic Publishers, MTP Press Limited,
Falcon House, Queen Square, Lancaster LAI lRN, UK
jar all other countries: Kluwer Academic Publishers Group, Distribution Center,
P.O. Box 322, 3300 AH Dordrecht, The Netherlands
Library of Congress Cataloging in Publication Data
ISBN-13: 978-1-4612-9644-7 e-ISBN-13: 978-1-4613-2631-1
DOl: 10.1007/978-1-4613-2631-1
Copyright
© 1985 by Martinus Nijhoff Publishing, Boston.
Softcover reprint of the hardcover 1s t edition 1985
All rights reserved. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted in any form or by any means, mechanical,
photocopying, recording, or otherwise, without the prior written permission of
the publishers,
Martinus Nijhoff Publishing, 190 Old Derby Street, Hingham, MA 02043, USA.
m
TRAVENOL
Acknowledgement
This publication has been made possible through the support of Travenol, which
is gratefully acknowledged.
VII
CONTENTS
Moderators IX
Speakers X
Foreword XI
Opening adress XIII
I. Source material
The future blood supply system in the USA: A prognosis
(F. Peetoom, S.M. Gaynor) 3
Plasma supply. National and international logistics, whole blood
versus plasmapheresis
(H.H. Gunson) 9
Processing criteria for recovery of FFP for fractionation
(J.K. Smith, D.R. Evans) 15
Donation procedure: Collection lesion, fibrinopeptide A, and
factor VIII
(C • V. Prowse) 25
Discussion 33
II. Technology of plasma fractionation
Small pool versus large pool in plasma fractionation: Reevaluation
of a concept
(C.Th. Smit Sibinga, P.C. Das) 43
Ethanol fractionation of human plasma: An overview
(H.G.J. Brummelhuis) 47
Control of large-scale plasma thawing
(P.R. Foster, A.J. Dickson) 57
Contributions to the optimization of factor VIII production:
Cryoprecipitation and controlled pore glass adsorption
(J. Over, M.P.J. Piet, J.A. Loos, H.P.J. Henrichs, P.J. Hoek,
M.A. von Meyenfeldt, J.I.H. Oh) 67
Chromatographic methods of plasma fractionation
(J .M. Curling) 79
Polyelectrolyte fractionation technology
(S • M. Middleton) 83
Recombinant DNA technology for the production of plasma
proteins
(W. D. Lake, W. R. Srigley) 89
VIII
Column ion exchange chromatographic production of albumin,
IV ISG and factor IX from 75,000 to 100,000 litres of plasma
per year
(A. D. Friesen) 97
Large scale chromatographic experiments for plasma fractionation
(F. Hask6, K. Krist6f, M. Salamon, P. Dob6) 105
Discussion 115
III. Safety aspects
Preservation of structure and function during isolation of human
plasma proteins
(Morgenthaler, E. Nydegger) 127
The impact of donor selection of virus transmission
(S. Iwarson) 139
Prevention of transmission of virus infections by blood trans-
fusions and removal of virus infectivity from clotting factor
concentrates
(R.J. Gerety) 143
Inactivation of hepatitis viruses (B, non-A/non-B) and retro-
viruses in pooled human plasma by means of i3-propiolactone-and
UV-treatment
(W. Stephan, H. Dichtelmiiller, R. Kotitschke, A.M. Prince,
R.R. Friis, H. Bauer) 147
HTLV-I/II and HTLV-III seroprevalence in blood product
recipients
(T .L. Chorba, J .M. Jason, J .S. McDougal) 155
Sero-epidemiology of the human T-lymphotropic retroviruses
HTVL-I and HTLV-III in the Netherlands
(J. Goudsmit) 163
Discussion 169
IV. Clinical aspects
Needs, quality versus quantity
(S. Seidl) 189
Clinical characteristics of the factor VIII protein from various
factor VIII concentrates
(I.M. Nilsson) 197
Clinical use of polyelectrolyte-fractionated porcine factor VIII
(P.B.A. Kernoff) 211
Factor VIII: C assay standardisation
(P.C. Das, P.H.M.J. Thijssen, R.L. McShine,
C. Th. Smit Sibinga) 217
The current of status of fibronectin in clinical medical practice
(E.L. Snyder) 223
Intravenous use of gammaglobulin in 1984
(J.B. Busse!) 231
Discussion 237
IX
MODERATORS
S. Seidl Red Cross Blood Transfusion Service Hessen
(chairman) Frankfurt am Main, FRG
H. G.J. Brummelhuis Central Laboratory of the Blood Transfusion
Amsterdam, NL
R. A. Coutinho Municipal Health Service Amsterdam,
Amsterdam, NL
H.H. Gunson National Blood Transfusion Service,
Manchester, UK
J. Over Central Laboratory of the Blood Transfusion
Amsterdam, NL
F. Peetoom American Red Cross Blood Services Portland,
OR, USA
J.K. Smith Plasma Fractionation Laboratory, Oxford,
UK
C. Th. Smit Sibinga Red Cross Blood Bank Groningen-Drenthe
Groningen, NL
x
SPEAKERS
J .B. Bussel The New York Hospital-Cornell Medical Center
New York, NY, USA
J. Curling Pharmacia Fine Chemicals, Uppsala, S
P.R. Foster Scottish National Blood Transfusion Service
Edinburgh, UK
R.J. Gerety Office of Biologics Research and Review
Bethesda, MD, USA
J. Goudsmit University of Amsterdam, Amsterdam, NL
S. Iwarson University of Goteborg, Goteborg, S
J .M. Jason Center for Infectious Diseases, Atlanta,
GA, USA
W.C. Lake Travenol Laboratories Inc. Deerfield,
IL, USA
S • H. Middleton Speywood Laboratories Ltd, Wexham, UK
1. M. Nilsson Allmanna Sjukhuset, Malmo, S
U .E. Nydegger Central Laboratory of the Swiss Blood
Transfusion Service, Bern, CH
C. V. Prowse Edinburgh and South-East Scotland Regional
Blood Transfusion Service Edinburgh, UK
E.L. Snyder Yale University, New Haven, CT, USA
PREPARED DISCUSSANTS
P.C. Das Red Cross Bloodbank Groningen-Drenthe,
Groningen, NL
A • D. Friesen The Winnipeg Rh Institute Inc., Winnipeg, C
F. Hasko National Institute of Haematology and Blood
Transfusion, Budapest, H
P.B.A. Kernoff Royal Free Hospital, London, UK
W. Stephan Biotest Pharma GmbH, Frankfurt, FRG
XI
FOREWORD
Plasma fractionation and blood transfusion are inherently linked. Blood
bankers need to have a sincere interest in fractionation and purification
techniques in order to understand the need for carefully controlled
source material collection and initial processing. Developments point to a
shift in technology, implementation and application of plasma fractions to
be produced, such that early anticipation from both bloodbankers and
fractionators in a joint interest and effort are needed.
As usual there is good news and bad news. We are referring in that
respect to the exciting presentation about the future of bloodbanking.
Although the blood donor still plays a major role in bloodbanking, new
technologies could terminate the conventional blood transfusion service
in the next 20-40 years. Sooner or later DNA technology will play an
important role in bloodbanking and bloodbankers will have to deal with
cultivated red cells as a replacement of our donor blood. Several
fractionation techniques like column chromatography, controlled pore
glass chromatography, heparin double cold precipitation technology and
polyelectrolite fractionation are available, which may result in better
yields for some of the plasma proteins. These techniques are likely to
replace in part the old Cohn fractionation in the near future.
For logistic reasons it should be reemphasized that sufficient FVIII yield
can be obtained from blood which has been stored for 18 hours. How
ever, it should also be kept in mind that significantly better yields are
achieved by fast freezing immediately following collection, the use of
CPDA anticoagulant or plasmapheresis by machines. -Additionally, the
yield may be influenced by the storage technique. It seems also likely
to further increase the FVIII yield by applying special absorption
techniques and the use of heparin.
An important point of discussion at present is whether a centralized
fractionation is always advantageous. It is our feeling that there are
certainly advantages when some of the plasma proteins, FVIII for in
stance, are prepared in regional centres. However, some other plasma
proteins still do require a more centralized approach. The solution for
the future might be a marriage of both systems.
Besides achievements of higher yields and better purities through newly
developed fractionation techniques, maintenance of function is a major
safety concern in plasma separation. To reduce the transmission of
infectious agents, new screening procedures are likely to be introduced
in the near future. For instance, reverse transcriptase as a test to
detect carriers of non A non B might be around the corner. For
hepatitis B effective screening procedures are already available as well