Study of three patients with thrombotic thrombocytopenic purpura exchanged with solvent/detergent-treated plasma: Is its decreased protein S activity clinically related to their development of deep venous thromboses?

Comparison of von Willebrand factor antigen, von Willebrand factor‐cleaving protease and protein S in blood components used for treatment of thrombotic thrombocytopenic purpura

“…Furthermore, the reduction in the higher molecular weight multimers detected in SD plasma (both Octaplas and Uniplas) and CSP provides a theoretical benefit over FFP and MB plasma (that retain the more biologically active highest molecular weight multimers) for the use in the management of TTP, because the largest polymers of VWF are often detected in TTP and are thought to be involved in the pathophysiology of the disease. Results from this study showed markedly reduced functional PS activity and reduced free PS antigen levels in SD plasma and confirm previous findings (Horowitz et al, 1992;Beeck & Hellstern, 1998;Leebeek et al, 1999;Flamholz et al, 2000;Hellstern & Haubelt, 2002;Doyle et al, 2003). Functional PS activity levels were within the normal range for the other components tested.…”

Comparison of von Willebrand factor antigen, von Willebrand factor‐cleaving protease and protein S in blood components used for treatment of thrombotic thrombocytopenic purpura

“…Furthermore, the reduction in the higher molecular weight multimers detected in SD plasma (both Octaplas and Uniplas) and CSP provides a theoretical benefit over FFP and MB plasma (that retain the more biologically active highest molecular weight multimers) for the use in the management of TTP, because the largest polymers of VWF are often detected in TTP and are thought to be involved in the pathophysiology of the disease. Results from this study showed markedly reduced functional PS activity and reduced free PS antigen levels in SD plasma and confirm previous findings (Horowitz et al, 1992;Beeck & Hellstern, 1998;Leebeek et al, 1999;Flamholz et al, 2000;Hellstern & Haubelt, 2002;Doyle et al, 2003). Functional PS activity levels were within the normal range for the other components tested.…”

Coagulation factor levels in cryosupernatant prepared from plasma treated with amotosalen hydrochloride (S‐59) and ultraviolet A light

“…CSP prepared from S-59-treated FFP was appropriately depleted of high-molecular-weight VWF and FVIII coagulant activity as measured by both functional and antigenic assays. Compared to other reports on plasma treated with the S/D pathogen inacti-vation process, the PS activity levels 13,16 and other physiologic inhibitors of coagulation were maintained within the normal reference range for citrated plasma and were similar to conventional FFP.…”

Venous thromboembolism associated with the management of acute thrombotic thrombocytopenic purpura

“…This is especially relevant in patients with TTP because the requirement of therapeutic anticoagulation is likely to be complicated by low platelet counts. Following the recent reports of VTE in TTP patients (Flamholz et al, 2000), and the events reported here, we recommend that VTE prophylaxis should be used in all acute TTP patients. Fitted graduated elastic compression stockings (class I) should be worn from the time of hospital admission, and prophylactic doses of low‐molecular‐weight heparin, in addition to low‐dose aspirin, should be administered when the platelet count rises above 50 × 10 9 /l.…”

Comparison of von Willebrand factor antigen, von Willebrand factor‐cleaving protease and protein S in blood components used for treatment of thrombotic thrombocytopenic purpura

“…Furthermore, the reduction in the higher molecular weight multimers detected in SD plasma (both Octaplas and Uniplas) and CSP provides a theoretical benefit over FFP and MB plasma (that retain the more biologically active highest molecular weight multimers) for the use in the management of TTP, because the largest polymers of VWF are often detected in TTP and are thought to be involved in the pathophysiology of the disease. Results from this study showed markedly reduced functional PS activity and reduced free PS antigen levels in SD plasma and confirm previous findings (Horowitz et al, 1992;Beeck & Hellstern, 1998;Leebeek et al, 1999;Flamholz et al, 2000;Hellstern & Haubelt, 2002;Doyle et al, 2003). Functional PS activity levels were within the normal range for the other components tested.…”

Coagulation factor levels in cryosupernatant prepared from plasma treated with amotosalen hydrochloride (S‐59) and ultraviolet A light

“…CSP prepared from S-59-treated FFP was appropriately depleted of high-molecular-weight VWF and FVIII coagulant activity as measured by both functional and antigenic assays. Compared to other reports on plasma treated with the S/D pathogen inacti-vation process, the PS activity levels 13,16 and other physiologic inhibitors of coagulation were maintained within the normal reference range for citrated plasma and were similar to conventional FFP.…”

Venous thromboembolism associated with the management of acute thrombotic thrombocytopenic purpura

“…This is especially relevant in patients with TTP because the requirement of therapeutic anticoagulation is likely to be complicated by low platelet counts. Following the recent reports of VTE in TTP patients (Flamholz et al, 2000), and the events reported here, we recommend that VTE prophylaxis should be used in all acute TTP patients. Fitted graduated elastic compression stockings (class I) should be worn from the time of hospital admission, and prophylactic doses of low‐molecular‐weight heparin, in addition to low‐dose aspirin, should be administered when the platelet count rises above 50 × 10 9 /l.…”

Comparison of von Willebrand factor antigen, von Willebrand factor‐cleaving protease and protein S in blood components used for treatment of thrombotic thrombocytopenic purpura

“…Furthermore, the reduction in the higher molecular weight multimers detected in SD plasma (both Octaplas and Uniplas) and CSP provides a theoretical benefit over FFP and MB plasma (that retain the more biologically active highest molecular weight multimers) for the use in the management of TTP, because the largest polymers of VWF are often detected in TTP and are thought to be involved in the pathophysiology of the disease. Results from this study showed markedly reduced functional PS activity and reduced free PS antigen levels in SD plasma and confirm previous findings (Horowitz et al, 1992;Beeck & Hellstern, 1998;Leebeek et al, 1999;Flamholz et al, 2000;Hellstern & Haubelt, 2002;Doyle et al, 2003). Functional PS activity levels were within the normal range for the other components tested.…”

Coagulation factor levels in cryosupernatant prepared from plasma treated with amotosalen hydrochloride (S‐59) and ultraviolet A light

“…CSP prepared from S-59-treated FFP was appropriately depleted of high-molecular-weight VWF and FVIII coagulant activity as measured by both functional and antigenic assays. Compared to other reports on plasma treated with the S/D pathogen inacti-vation process, the PS activity levels 13,16 and other physiologic inhibitors of coagulation were maintained within the normal reference range for citrated plasma and were similar to conventional FFP.…”

Venous thromboembolism associated with the management of acute thrombotic thrombocytopenic purpura

“…This is especially relevant in patients with TTP because the requirement of therapeutic anticoagulation is likely to be complicated by low platelet counts. Following the recent reports of VTE in TTP patients (Flamholz et al, 2000), and the events reported here, we recommend that VTE prophylaxis should be used in all acute TTP patients. Fitted graduated elastic compression stockings (class I) should be worn from the time of hospital admission, and prophylactic doses of low‐molecular‐weight heparin, in addition to low‐dose aspirin, should be administered when the platelet count rises above 50 × 10 9 /l.…”