Background and objectives: The aim of this study was to determine the potencies
of factor VII (FVII) and of activated FVII (FVIIa) in prothrombin complex
concentrates (PCC). Materials and methods: We examined 56 lots of
PCC from 5 manufacturers. Three brands were licensed preparations, and 1 product
scries had been involved in thromboembolic complications. FVII and FVIIa
were measured using a two-stage amidolytic assay and a specific clotting assay,
respectively. We also quantified FVII clotting activity by a one-stage assay reflecting
a mixture of FVII zymogen and FVIIa. Results: All PCC contained
substantial amounts of FVII, and FVIIa could be detected in all lots. There were
marked differences between manufacturers and some significant variabilities between
batches. The two lots involved in thromboembolic events contained considerably
more FVIIa than the PCC still licensed. The lowest FVIIa potencies
were observed in an experimental product series, indicating that PCC can be
produced without activation of FVII during the manufacturing process. Conclusion:
FVIIa is present in all PCC containing FVII. High FVIIa potencies may
contribute to the thrombogenic potential of these preparations, and determination
of FVIIa potencies should be included in the in vitro characterization of
PCC.
FVIIa is present in all PCC containing FVII. High FVIIa potencies may contribute to the thrombogenic potential of these preparations, and determination of FVIIa potencies should be included in the in vitro characterization of PCC.
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