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Effects of Desmopressin on Normal Donors in Plasma Exchange Donations

  • Richard J. Sassetti
  • Bruce C. McLeod
Part of the NATO ASI Series book series (NSSA, volume 242)

Abstract

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.

Keywords

Factor Viii Single Donor Therapeutic Plasma Exchange Factor Viii Level Factor Viii Content 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    McLeod BC, Sassetti RJ, Cole ER, Pierce MI. Factor VIII collection by pheresis. Lancet 1980; 2: 671–673.PubMedCrossRefGoogle Scholar
  2. 2.
    McLeod BC, Scott JP. Transfusion studies of “single donor” factor VIII from plasma exchange donation. JAMA 1984; 252: 2726–2729.PubMedCrossRefGoogle Scholar
  3. 3.
    McLeod BC, Sassetti RJ, Cole EP, Scott JP. A high-potency, single donor cryoprecipitate of known factor VIII content dispensed in vials. Ann Intern Med 1987; 106: 35–40.PubMedGoogle Scholar
  4. 4.
    McLeod BC, Sassetti RJ. Plasmapheresis with return of cryoglobulin depleted autologous plasma (cryoglobulinpheresis) in cryoglobulinemia. Blood 1980; 55: 866–870.PubMedGoogle Scholar
  5. 5.
    Mason EC. Thaw-siphon technique for production of cryopre-cipitate concentrate of factor Vm. Lancet 1987; 2: 15–17.Google Scholar
  6. 6.
    Kang EP. An improved thaw-siphon method for cryoprecipitate preparation. Vox Sang 1980; 38: 172–177.PubMedCrossRefGoogle Scholar
  7. 7.
    Mannucci PM, Ruggeri ZM, Pareti FI, Capitanio A. 1-Deamino-8-D-arginine vasopressin: a new pharmacological approach to the management of hemophilia and von Willebrand’s disease. Lancet 1977; 1: 869–872.PubMedCrossRefGoogle Scholar
  8. 8.
    Nilsson IM, Walter H, Mikaelsson M, Vilhardt H. Factor VIII concentrate prepared from DDAVP stimulated blood donor plasma. Scand J Haematol 1979; 22: 42–46.PubMedCrossRefGoogle Scholar
  9. 9.
    McLeod B. Myocardial infarction in a blood donor after administration of desmopressin. Lancet 1990; 336: 1137–1138.PubMedCrossRefGoogle Scholar
  10. 10.
    Scott JP, McGann K, Gill JS, McLeod BC, Gamerman S. Is immune function altered by the infusion of high protein load material in the treatment of hemophilia A? Ped Res 1988; 23: 347A.Google Scholar
  11. 11.
    McLeod B, Kisker T, Hasegawa A, Edson R, Gamerman SA, Scott P. Incidence of inhibitors in hemophiliacs treated with single donor cryoprecipitate from plasma exchange donation. Blood 1989; 74(Suppl 1): 37A.Google Scholar
  12. 12.
    McLeod BC, McKenna R, Sassetti RJ. Treatment of von Willebrand’s disease and hypofibrinogenemia with single donor cryoprecipitate from plasma exchange donation. Am J Hematol 1989; 32: 112–116.PubMedCrossRefGoogle Scholar
  13. 13.
    Ingram GIC. Increase in antihemophilic globulin activity following infusion of adrenaline. J Physiol 1961; 156: 217–224.PubMedGoogle Scholar
  14. 14.
    Egeberg O. Changes in the activity of antihemophilic A factor (f, VHI) and in the bleeding time associated with muscular exercise and adrenaline infusion. Scand J Clin Lab Invest 1963; 15: 539–549.PubMedCrossRefGoogle Scholar
  15. 15.
    Matsui Y, Martin-Alocio S, Doenges E, Christenson L, Shapiro HM, Yunis EJ, Page PL. Effects of frequent and sustained plateletpheresis on peripheral blood mononuclear cell populations and lymphocyte functions of normal plasma volunteer donors. Transfusion 1986; 26: 446–452.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1993

Authors and Affiliations

  • Richard J. Sassetti
    • 1
  • Bruce C. McLeod
    • 1
  1. 1.Blood CenterRush-Presbyterian-St. Luke’s Medical CenterChicagoUSA

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