Determining Concentrations of Factors VIII, IX and Fibrinogen in Fresh Frozen Plasma: An Alternative to Improve Treatment of Hemorrhagic Diseases in a Developing Country

Fresh frozen plasma (FFP) remains the only treatment of bleeding events in some developing countries. But access to this blood derived-product could be difficult. Determined the concentrations of coagulation factors VIII, IX and fibrinogen used in Mali. We have determined prospectively the concentrations of these factors from October 2015 to February 2016 in the FFP bags produced and distributed by the National Blood Transfusion Center (NBTC) in Mali. The assays were performed in the laboratory of medical biology in Hôpital du Mali (Bamako, Mali) using a semi automaton BioSolea4. Mean volume of 342 analyzed blood bags was 249.5 ± 42.7 mL (range: 130 - 374.4). Mean concentration of factor VIII was 0.4 ± 0.4 IU/mL (0.02-3.56 IU/mL), of factor IX 0.3 ± 0.2 IU/mL (0.05-1.5 IU/mL) and of fibrinogen: 2.6 ± 0.8 g/L (0.2- 4.8 g/L). As expected, concentration of factor VIII of the O group donors was lower than in other blood groups (0.3±0.3 vs 0.4±0.5 IU/mL) (p=0.009). Similar results were obtained with rhesus positive blood bags donors compare to those from others blood groups (0.3±0.3 vs 0.4±0.4 IU/mL) (p = 0.001). Conclusion: Concentrations of coagulation factors in the FFP bags produce by NBTC are 1.6 fold lower for factor VIII, and 2.3 fold for factor IX than in other countries. We suggest that the production and distribution of cryoprecipitate could be improved for the effective management of bleeding events in resource-limited countries with no access to specific concentrate coagulation factor.