Thromb Haemost 1984; 51(03): 379-384
DOI: 10.1055/s-0038-1661106
Original Article
Schattauer GmbH Stuttgart

Use of Porcine Factor VIII in the Management of Seventeen Patients with Factor VIII Antibodies

Authors

  • Loredana Gatti

    The A. Bianchi Bonomi Hemophilia and Thrombosis Centre, University of Milano and Maggiore Hospital, Milano, Italy
  • Pier Mannuccio Mannucci

    The A. Bianchi Bonomi Hemophilia and Thrombosis Centre, University of Milano and Maggiore Hospital, Milano, Italy
Further Information

Publication History

Received 17 February 1984

Accepted 09 April 1984

Publication Date:
19 July 2018 (online)

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Summary

A polyelectrolyte-fractionated porcine factor VIII concentrate was given to 16 hemophiliacs with anti-F VIII antibodies (Ab) and to a woman with post-partum-acquired Ab during 24 courses of treatment including three major surgical procedures. Before treatment, antiporcine F VIII Ab was always lower than antihuman F VIII Ab, with a median cross reactivity of 32%. After treatment, the mean rise in F VIII was 1.5 U/dl/Unit infused/Kg b.w. and in vivo recovery was 50% of the theoretical values. Anamnestic rises in anti-porcine F VIII Ab (3 × the baseline titer) were seen after 9 of 22 courses of treatment with porcine F VIII only; similar rises in anti-human F VIII Ab, after 6 courses of treatment; median cross reactivity did not change significantly. Lower than expected increases in plasma F VIII without marked changes in Ab titers and severe thrombocytopenia occurred during surgery in two patients. Porcine F VIII is a rational and effective therapeutic choice for patients who have anti-human Ab titers above 10 U/ml; it can solve clinical situations that would otherwise be very difficult to manage; anamnesis is perhaps less frequent than after human F VIII; however, the incidence of thrombocytopenia, resistance and other side- effects is still higher than desirable.