by L. Sutor, M.D., Vice President of Medical and Technical Services, Carter BloodCare
Carter BloodCare is now stocking OctaplasTM as an alternative plasma product. OctaplasTM is a pooled, solvent/detergent-treated plasma product made from 630 to 1520 donors of the same blood type. The FDA has approved it for use in patients with acquired deficiency of multiple coagulation factors due to liver disease, patients undergoing cardiac surgery and liver transplantation, or patients undergoing therapeutic plasma exchange for thrombotic thrombocytopenic purpura (TTP).
This product may be attractive for patients receiving large volumes of plasma, such as TTP patients; or other patients in whom it might be desirable to further reduce the already low risk of transfusion-transmitted infection. The other appeal of pooled plasma products such as OctaplasTM is an apparent lower risk of antibody-mediated transfusion-related acute lung injury (TRALI), because any antibody from a contributing donor would be diluted out in the pool.
The price is higher for OctaplasTM than for conventional plasma because of the additional treatment and processing steps this product has undergone. The units are standardized at 200 ml and have a maximum shelf life of 3 years when stored at -18 degrees C or lower. Like conventional plasma, OctaplasTM is available in A, B, O and AB blood types.
As for safety issues, the solvent/detergent processing may lead to lower levels of Protein S and alpha 2-antiplasmin, and coagulation abnormalities have been described in some patient populations due to these changes. Not all infectious disease organisms are destroyed by the solvent/detergent treatment, which is most effective against lipid enveloped organisms.