(2) Paying for blood | Thicker Than Water; Prejudice and misconception leave the huge global market for life-saving blood-plasma products dangerously reliant on America.
https://www.economist.com/intern ... vital-global-market
Quote:
"Global plasma exports were worth $126bn in 2016—more than exports of aeroplanes.
"Canadian reservations about paid plasma are shared across most of the world. America, China, parts of Canada and some European countries are among the few places that permit it. Those countries are extremely effective in securing supplies: three-quarters are collected in America alone, and another 10% in China, Germany, Hungary and Austria, where payment is also allowed. Of over 1,000 plasma-collection centres worldwide, 700 are in America (see article [absolutely no need to read it]).
"Only countries that pay for plasma are self-sufficient in it. (Italy, where donors are given time off work, is close to self-sufficiency.) Half of America’s plasma is shipped to Europe—20m contributions-worth. Canada imports 80% of its plasma products from America. Australia imports 40% of its plasma products, too.
Drug firms from countries that have banned pay-for-plasma do much of their collection in America. Three of the largest collection companies are European: Grifols of Spain, Shire of Ireland and Octapharma of Switzerland. The parent company of another big collector, CSL Behring, is Australian. Together these four firms run nearly eight out of ten plasma-collection centres. Some of their manufacturing capacity is in America, but much is located elsewhere. Switzerland, which collects very little plasma, exported $26bn-worth of plasma products in 2016.
Exported plasma is used to manufacture pharmaceuticals and is distinct from the plasma [sic; should be 'blood'] that, with red and white blood-cells and platelets, is used for transfusion. That saves lives when blood is lost, say, in traumatic accidents or surgery. But whole blood is rarely traded across borders, and very rarely involves payment. The World Health Organisation's safety guidelines recommend voluntary donations. Happily, demand for transfusions is declining. Blood-bank management and modern medicine have both grown more efficient. * * * Despite population growth, the number of red blood-cell units used by hospitals in England has dropped from 2m a year 15 years ago to 1.4m now. * * * Historically, these products were derived from plasma collected when volunteers donated whole blood [but presently plasma is collected via apheresis.]
Note:
(a) Quotation 1 will be explored in the next posting.
(b) Mazurkiewicz-Pisarek A et al, The Factor VIII Protein and Its function. Acta Biochimica Polonica, 63: 11-16 (2016)
www.actabp.pl/pdf/1_2016/2015_1056.pdf
(Human coagulation factor VIII is "synthesized mainly in hepatocytes * * * It is one of the largest coagulation factors (2332 amino acids, molecular weight of 293 kDa) * * * The half-life of coagulation factor VIII is about 12 hours. The active form of factor VIII is a non-enzymatic cofactor * * * The gene for factor VIII is located on the X chromosome * * * Hemophilia A [from a mutation in factor VIII gene causing production of half amount of this factor] is diagnosed in 1 of 5000 male newborns. * * * In approximately 30–50% of affected patients mutation occurs spontaneously and their family history is negative. * * * [human gene for Factor VIII was cloned and sequenced in 1984] Unfortunately, at present only in some countries, for example Canada and Ireland, 100% of affected patients receive recombinant factor VIII. In The United States that percentage is about 65% and in many rich and highly developed countries of the European Union this ratio is significantly lower. In Poland, only coagulation factor concentrates manufactured from human plasma are used. The reason for that is very high production cost of recombinant factor VIII")
(c) "A complication known as Rhesus disease, in which the blood type of a fetus is incompatible with the mother’s was responsible for 10% of stillbirths in America as recently as the 1960s. These days plasma products can save the child."
(i) The name of Rh incompatibility comes from rhesus monkeys.
(A) The Virginia Apgar Paper. In Profile in Science, US National Library of Medicine (NLM), undated
https://profiles.nlm.nih.gov/ps/retrieve/ResourceMetadata/CPBBGL
("Speaking to the Seventh Annual Immunization Conference at the National Communicable Disease Center (now the Centers for Disease Control), Apgar [on Mar 26, 1970] reviewed the great progress made in the knowledge, treatment, and prevention of Rh disease. * * * Transcript: * * * In 1940, it was found that injection of red blood cells of the rhesus monkey into rabbits produced a serum factor which caused the agglutination of monkey red cells. When tried with red blood cells of human beings, about 85% of individuals showed agglutination of red cells, while 15% did not. There was no sex difference. P. Levine and associates then cleared the way by pointing out that incompatible transfusions, or injections of incompatible intramuscular blood, caused sensitization")
(B) rhesus macaque
https://en.wikipedia.org/wiki/Rhesus_macaque
(see map for current range)
Quote: "The name 'rhesus' is reminiscent of the Greek mythological king, Rhesus. However, the French naturalist Jean-Baptiste Audebert, who applied the name to the species, stated: 'it has no meaning.'
(C) Virginia Apgar
https://en.wikipedia.org/wiki/Virginia_Apgar
(1909 – 1974; American; is best known as the inventor of the Apgar score, a way to quickly assess the health of newborn children immediately after birth)
(ii)"These days plasma products can save the child."
The last sentence in the quotation is wrong, to the extent that it implies administration of anti-Rh immunoglobulin to a newborn or child to save it -- instead, it should be to the mother, to prevent incompatibility of her future Rh-positive child(ren). "Rh disease is generally preventable by treating the mother during pregnancy or soon after delivery with an intramuscular injection of anti-RhD immunoglobulin." en.wikipedia.org for "Rh disease."
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发表于 5-19-2018 12:33:58
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