Preparation and administration

Factor concentrates are the treatment of choice in many inherited coagulation factor deficiencies. They are prepared from pooled donor plasma by fractionation ('intermediate-purity' products) or by chromatographic methods ('high-purity' products). All then undergo viricidal procedures such as pasteurization or solvent-detergent sterilization to reduce the risk of viral transmission to an absolute minimum. They are manufactured in lyophilized form and are reconstituted with small volumes of water for administration. Factor concentrates are currently available for most of the inherited factor deficiencies (fibrinogen, II, VII, VIII, IX, X, XI, XIII) and also for deficiencies of natural anticoagulants (protein C and antithrombin III concentrates), but treatment options should always be discussed with a hematologist as some concentrates may precipitate thrombosis. A recombinant form of factor VIII which avoids the need to give products from donor plasma is now available for hemophilia A but is very expensive.

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