Читать книгу Transfusion Medicine - Jeffrey McCullough - Страница 153

Treatment of fresh plasma with a combination of solvent tri‐n‐butyl‐phosphate and the detergent Triton X‐100 inactivates lipid envelope viruses while retaining most coagulation factor activity. The process must be done on a large scale, and plasma from about 2,500 donors is pooled for the SD process. The product has little, if any, risk for transmitting lipid envelope viruses, such as HIV, hepatitis C virus, and hepatitis B virus, but can transmit nonlipid envelope viruses such as parvovirus [124]. Reports of thrombosis in patients with thrombotic thrombocytopenic purpura who are undergoing plasma exchange with SD plasma [125] and deaths in patients receiving SD plasma while undergoing liver transplantation led to withdrawal of an earlier version of that product from the market. It is postulated that these thrombotic complications were due to decreased protein S and plasmin inhibitor activity in SD plasma [125]. A different SD plasma, Octaplas (Octapharma, Vienna, Austria) (Table 5.11), has higher, although not normal, levels of protein S and plasmin inhibitor [126] and has not been associated with thrombotic events. This form of SD‐treated plasma is in rather wide use in Europe [127, 128] and is now available in the United States.