Use of 'single donor' factor VIII from plasma exchange donation

B. C. McLeod and J. P. Scott

We investigated the advantages of using "single donor" factor VIII derived from a new cyclic apheresis donation (plasma exchange donation) to treat hemophiliac children. By selecting donors with high factor VIII levels and using thaw-siphon isolation of cryoprecipitate, we achieved a mean yield of 1,360 units of factor VIII per weekly donation. The half-life, posttransfusion increments, and clinical efficacy of factor VIII in this material are comparable with those of factor VIII from other sources. A single donor has provided total support for seven months for one patient with severe hemophilia, and another for 24 months for a patient with mild hemophilia. Other patients have been supported through major surgery or CNS hemorrhage by a single donor. This approach to factor VIII replacement is hemostatically effective and can substantially decrease donor exposure for both major and minor bleeding episodes. The reduction in donor exposure should result in a reduced risk of acquiring hepatitis and perhaps the acquired immune deficiency syndrome in patients with hemophilia A.