Products for Clotting Factor Replacement in Developing Countries

Carol K. Kasper

doi:10.1055/s-2005-922221

Seminars in Thrombosis and Hemostasis, Table of Contents

Semin Thromb Hemost 2005; 31(5): 507-512
DOI: 10.1055/s-2005-922221

Products for Clotting Factor Replacement in Developing Countries

Carol K. Kasper¹

¹Emerita Professor, University of Southern California, Los Angeles, California

Abstract

ABSTRACT

Developing countries provide clotting factor replacement for hemophilia patients using one or more of the following strategies. (1) Production of domestic plasma and cryoprecipitate provides some self-sufficiency but depends heavily on the presence of an excellent blood transfusion service. The risk of transmitting donor infections is not completely obviated even with good serologic testing. (2) Domestic plasma fractionation has been achieved in a handful of emerging countries but can be expensive. Patients may distrust businessmen of their own country and may be dissatisfied with the style of product available from domestic plants. (3) Contract fractionation has been successful when the donor country is able to provide adequate amounts of well-tested plasma. Its cost is not always lower than that of imported concentrate but a degree of national self-sufficiency is retained. (4) Importation of concentrate allows a wide choice of products. The selection should focus not only on price but also on product safety, which depends upon well-validated donor testing and viral inactivation. High levels of purification are not of great importance. Successful national hemophilia programs also address organization of care, sensible dosing, and equitable distribution of resources to gain the maximum benefit from scarce resources.

KEYWORDS

Developing countries - hemophilia - cryoprecipitate - factor VIII - plasma

Full Text

References

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Carol K KasperM.D.

International Hemophilia Training Center, Orthopedic Hospital

2400 South Flower Street, Los Angeles, CA 90007

Email: ckasper@laoh.ucla.edu