Effects of Desmopressin on Normal Donors in Plasma Exchange Donations
The use of desmopressin (DDAVP) to stimulate increased factor VIII in plasmapheresis donors was an evolutionary step in our efforts to use cryoprecipitate produced by repetitive large volume (2-3 L) plasma exchange of dedicated donors for treatment of hemophilia A.1, 2,3 The donation procedure evolved from our experience in the treatment of cryoglobulinemia by plasmapheresis.4 To reduce replacement fluid cost and minimize the risk of disease transmission for patients undergoing repeated plasmapheresis we had explored the feasibility of using the cryoglobulin-depleted plasma from a previous donation as the replacement fluid in a therapeutic plasma exchange. Being persuaded of the efficacy and safety of the procedure, we were led to consider an analogous procedure, performed on dedicated blood donors, as a source of large quantities of cryoprecipitate. The principle advantage perceived for such a program was a reduction in the risk of disease transmission by minimizing the number of donors to which a hemophilic patient is exposed. Awareness that desmopressin should raise donor factor VIII to levels 3 to 4 times baseline suggested that it might enhance the performance of the donation, resulting in higher yields and lower per-unit cost.
KeywordsFactor Viii Single Donor Therapeutic Plasma Exchange Factor Viii Level Factor Viii Content
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