Review And Current Status of Hyperimmune Plasma for Snake Antivenoms in Taiwan

DOI: 10.6524/EB.202404_40(7).0002

Chien-Hsin Liu^*, Rang-Hui Yeh, Chao-Hung Chen, Wen-Chin Hsieh

2024 Vol.40 NO.7

Correspondence Author： Chien-Hsin Liu^*

Abstract：

        In Taiwan, there are six clinically significant vipers, including Deinagkistrodon acutus, Trimeresurus stejnegeri, Protobothrops mucrosquamatus, Daboia russelii siamensis, Bungarus multicinctus and Naja atra. To save people from envenoming, Taiwan Centers for Disease Control produces and supplies four antivenoms for six vipers from hyperimmune horse. To find a suitable horse facility, the farm was moved several times and finally settled down at the national immunization horse farm in 2019, with Pharmaceutical Inspection Co-operation Scheme (PIC/S) and Good Manufacturing Practice, (GMP) designation. Consequently, the following processes can comply with regulations, including antigen preparation, immunization, blood collection, plasma collection, and reinfusion. 
        Recently we overcame the obstacle of low success rate and low titers for hyperimmune plasma of Trimeresurus stejnegeri, and the production capacity increased by approximately 36 times. Meanwhile, we also reduced and refined the use of venom in horses, which led to decreasing the quantity of horses used and the side effects of immunization on horses. 
        In the future, we will further improve the production capacity for other hyperimmune plasma and establish plasmapheresis on plasma production to ensure the health and safety of people with snakebites envenoming in Taiwan.