Journal of Clinical Apheresis最新文献

筛选
英文 中文
Early Recognition of Retinal Signs in Waldenström's Macroglobulinemia: Implications for Therapeutic Plasma Exchange 早期识别视网膜征象Waldenström的大球蛋白血症:治疗血浆交换的意义
IF 1.4 4区 医学
Journal of Clinical Apheresis Pub Date : 2025-05-07 DOI: 10.1002/jca.70031
Álvaro Ponce-de-León, Alfonso Miranda-Sánchez, Alicia Valverde-Megias
{"title":"Early Recognition of Retinal Signs in Waldenström's Macroglobulinemia: Implications for Therapeutic Plasma Exchange","authors":"Álvaro Ponce-de-León,&nbsp;Alfonso Miranda-Sánchez,&nbsp;Alicia Valverde-Megias","doi":"10.1002/jca.70031","DOIUrl":"https://doi.org/10.1002/jca.70031","url":null,"abstract":"<div>\u0000 \u0000 <p>This report highlights the pivotal role of ophthalmologists in recommending therapeutic plasma exchange (TPE) for systemic disorders like Waldenström's macroglobulinemia (WM). A patient with suspected WM underwent ophthalmic evaluation, revealing peripheral retinal hemorrhages and Roth spots despite no visual complaints. Fundus imaging documented these changes, correlating with elevated IgM levels (86.32 g/L), indicative of hyperviscosity syndrome (HVS). Early retinal findings prompted TPE to mitigate HVS complications. Subsequent bone marrow biopsy confirmed WM with the MYD88 L265P mutation. This case underscores the importance of ophthalmologic insights in guiding hematologic interventions and improving outcomes.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"40 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cost-Effectiveness of Preemptive Plerixafor Versus Rescue Plerixafor for Mobilization and Collection of Hematopoietic Stem Cells in Patients With Multiple Myeloma and Lymphoma 在多发性骨髓瘤和淋巴瘤患者中,先发制人的普立沙福与抢救普立沙福动员和收集造血干细胞的成本效益
IF 1.4 4区 医学
Journal of Clinical Apheresis Pub Date : 2025-05-03 DOI: 10.1002/jca.70026
Roselene Mesquita Augusto Passos, Miriam Allein Zago Marcolino, Júlia Augusto Passos, Vinicius Fernando Calsavara, Leila de Lourdes Martins Perobelli, Alessandro Gonçalves Campolina, Cesar de Almeida-Neto
{"title":"Cost-Effectiveness of Preemptive Plerixafor Versus Rescue Plerixafor for Mobilization and Collection of Hematopoietic Stem Cells in Patients With Multiple Myeloma and Lymphoma","authors":"Roselene Mesquita Augusto Passos,&nbsp;Miriam Allein Zago Marcolino,&nbsp;Júlia Augusto Passos,&nbsp;Vinicius Fernando Calsavara,&nbsp;Leila de Lourdes Martins Perobelli,&nbsp;Alessandro Gonçalves Campolina,&nbsp;Cesar de Almeida-Neto","doi":"10.1002/jca.70026","DOIUrl":"https://doi.org/10.1002/jca.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Plerixafor combined with granulocyte colony-stimulating factor (G-CSF) has shown superior efficacy in mobilizing hematopoietic stem cells (HSCs). However, its widespread use is constrained by high costs, and there is ongoing debate regarding the effectiveness of mobilization strategies. This study evaluated the cost-effectiveness of preemptive versus rescue plerixafor in patients from the Brazilian Public Health Care System with multiple myeloma or lymphoma eligible for autologous stem cell transplantation (ASCT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This observational study assessed the costs and clinical outcomes of preemptive and rescue plerixafor strategies. The incremental cost-effectiveness ratio (ICER) was calculated for the percentage of patients with successful optimal or minimal HSC collections, who underwent ASCT and the number of leukapheresis sessions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 285 patients, 82 in the preemptive and 203 in the rescue group. Preemptive plerixafor resulted in a lower mobilization failure rate, a decreased need for remobilization, a higher proportion of patients progressing to ASCT, and a shorter interval between the beginning of mobilization and ASCT. The incremental cost of preemptive versus rescue plerixafor was US$ 1532.44. The incremental effectiveness observed was 10.1% for minimally successful harvest (ICER US$ 151.28), 4.7% for optimal harvest (ICER US$ 326.05), and 13.1% for patients progressing to ASCT (ICER US$ 116.18). Regarding the number of leukapheresis sessions, preemptive plerixafor was dominated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Summary</h3>\u0000 \u0000 <p>Preemptive plerixafor is a cost-effective strategy compared to rescue plerixafor, offering higher efficacy and lower ICER values, making it a clinically beneficial option despite its higher cost.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"40 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jca.70026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Granulocyte and Monocyte Adsorptive Apheresis Maintenance Therapy Restored the Loss of Response to Anti-TNF-Alpha Agents in the Patients With UC: A Case Report 粒细胞和单核细胞吸附分离维持治疗恢复UC患者对抗tnf - α药物的反应丧失:一个病例报告
IF 1.4 4区 医学
Journal of Clinical Apheresis Pub Date : 2025-05-02 DOI: 10.1002/jca.70030
Nobuhiro Ueno, Yu Kobayashi, Aki Sakatani, Tatsuya Dokoshi, Keitaro Takahashi, Katsuyoshi Ando, Shin Kashima, Kentaro Moriichi, Hiroki Tanabe, Yuki Kamikokura, Mishie Tanino, Mikihiro Fujiya
{"title":"Granulocyte and Monocyte Adsorptive Apheresis Maintenance Therapy Restored the Loss of Response to Anti-TNF-Alpha Agents in the Patients With UC: A Case Report","authors":"Nobuhiro Ueno,&nbsp;Yu Kobayashi,&nbsp;Aki Sakatani,&nbsp;Tatsuya Dokoshi,&nbsp;Keitaro Takahashi,&nbsp;Katsuyoshi Ando,&nbsp;Shin Kashima,&nbsp;Kentaro Moriichi,&nbsp;Hiroki Tanabe,&nbsp;Yuki Kamikokura,&nbsp;Mishie Tanino,&nbsp;Mikihiro Fujiya","doi":"10.1002/jca.70030","DOIUrl":"https://doi.org/10.1002/jca.70030","url":null,"abstract":"<p>Ulcerative colitis (UC) is a chronic inflammatory condition requiring lifelong management, with anti-tumor necrosis factor α (anti-TNF-α) agents often used for refractory cases. However, secondary loss of response (LOR) to these agents, due to anti-drug antibodies, poses a significant therapeutic challenge. This report describes a case where granulocyte and monocyte adsorptive apheresis (GMA) maintenance therapy successfully restored the efficacy of an anti-TNF-α agent in a 26-year-old male with active UC experiencing LOR to infliximab. Following GMA induction therapy and continued infliximab administration, clinical symptoms improved, fecal calprotectin levels decreased, and clinical remission was achieved. Long-term maintenance with GMA enabled sustained clinical remission, with mucosal healing observed one year post-therapy. This case suggests that GMA maintenance therapy may serve as a novel therapeutic approach for patients with active UC experiencing LOR to anti-TNF-α agents. However, further studies are warranted to elucidate the underlying mechanisms and validate its efficacy.</p>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"40 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jca.70030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Challenges in Autologous Peripheral Blood Stem Cell Collection in a Patient With IgM Myeloma and Cryoglobulinaemia IgM骨髓瘤和冷球蛋白血症患者自体外周血干细胞收集的挑战
IF 1.4 4区 医学
Journal of Clinical Apheresis Pub Date : 2025-04-28 DOI: 10.1002/jca.70029
Julie Gillies, Samantha Drummond
{"title":"Challenges in Autologous Peripheral Blood Stem Cell Collection in a Patient With IgM Myeloma and Cryoglobulinaemia","authors":"Julie Gillies,&nbsp;Samantha Drummond","doi":"10.1002/jca.70029","DOIUrl":"https://doi.org/10.1002/jca.70029","url":null,"abstract":"<div>\u0000 \u0000 <p>Cold agglutinins are well recognized to complicate stem cell harvests. There is recognition that in both the collection, the processing, and reinfusion of the stem cells to the patient, the product could be exposed to lower temperatures, and this could affect the cold agglutinins within. There is little published evidence on peripheral blood stem cell (PBSC) collection in patients with cryoglobulinaemia. We would like to present a gentleman who has IgM myeloma and Type 1 cryoglobulinaemia. The patient was young and fit, and the plan was to consolidate his induction chemotherapy with an autologous stem cell transplant (ASCT).</p>\u0000 <p>We would like to discuss the challenges that we faced in this gentleman in trying to harvest stem cells to utilize for the purposes of performing an ASCT. These challenges occurred because of 1. progressive disease, causing an inevitable rise in cryoglobulin levels that prevented therapeutic plasma exchange and stem cell collection and 2. the myelosuppressive effects of the chemotherapeutic agent prohibiting an adequate stem cell dose required to proceed to transplant. We would like to describe the measures that we put in place in trying to collect PBSC in this patient, to utilize for the purposes of performing an ASCT.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"40 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Antidote Worse Than the Poison? Emergent Therapeutic Plasma Exchange After Overzealous Intravenous Lipid Emulsion Infusion During Treatment of Local Anesthetic Systemic Toxicity 解药比毒药更糟糕?局麻全身性毒性治疗中过度静脉输注脂乳后紧急血浆交换
IF 1.4 4区 医学
Journal of Clinical Apheresis Pub Date : 2025-04-21 DOI: 10.1002/jca.70025
Brooke Yasgur, Ari Filip, Pratheepa Ravikumar, Logan Meurer, Gina Drobena
{"title":"Antidote Worse Than the Poison? Emergent Therapeutic Plasma Exchange After Overzealous Intravenous Lipid Emulsion Infusion During Treatment of Local Anesthetic Systemic Toxicity","authors":"Brooke Yasgur,&nbsp;Ari Filip,&nbsp;Pratheepa Ravikumar,&nbsp;Logan Meurer,&nbsp;Gina Drobena","doi":"10.1002/jca.70025","DOIUrl":"https://doi.org/10.1002/jca.70025","url":null,"abstract":"<div>\u0000 \u0000 <p>This case report describes therapeutic plasma exchange as treatment for a rare instance of severe hypertriglyceridemia following high-dose intravenous lipid emulsion (ILE) therapy for bupivacaine-induced local anesthetic systemic toxicity (LAST). The patient received a cumulative ILE dose of 28.0 mL/kg to control seizures, exceeding the typical recommended maximum dose of 10 mL/kg. Clinical presentation included severe headache, visual disturbances, and photophobia, concerning for hyperviscosity syndrome. Laboratory findings revealed a markedly elevated serum triglyceride concentration (&gt; 10 350 mg/dL). Therapeutic plasma exchange with plasma was successfully employed to rapidly reduce serum triglycerides and alleviate symptoms. This case highlights the potential for severe iatrogenic hypertriglyceridemia associated with high-dose ILE therapy for LAST and emphasizes the importance of close clinical monitoring and timely intervention.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"40 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Therapeutic Plasma Exchange: Analysis of Practices and Compliance With International Guidelines 治疗性血浆置换:实践分析及对国际指南的遵从性
IF 1.4 4区 医学
Journal of Clinical Apheresis Pub Date : 2025-04-17 DOI: 10.1002/jca.70023
Davi Mesquita Miranda, Marina Vilela Pires Coelho, Márcia Torresan Delamain, Raquel A. Fabreti-Oliveira
{"title":"Therapeutic Plasma Exchange: Analysis of Practices and Compliance With International Guidelines","authors":"Davi Mesquita Miranda,&nbsp;Marina Vilela Pires Coelho,&nbsp;Márcia Torresan Delamain,&nbsp;Raquel A. Fabreti-Oliveira","doi":"10.1002/jca.70023","DOIUrl":"https://doi.org/10.1002/jca.70023","url":null,"abstract":"<div>\u0000 \u0000 <p>Therapeutic plasma exchange (TPE) is widely used in the treatment of autoimmune diseases and hematological emergencies. It is also applied in transplant patients for the desensitization of anti-HLA (human leukocyte antigen) antibodies and the management of antibody-mediated rejection. This study aims to assess the epidemiology of therapeutic plasmapheresis and evaluate whether indications for plasmapheresis align with the guidelines of the American Society for Apheresis (ASFA) and investigate the associated adverse effects. This retrospective observational study was conducted in hospitals in Belo Horizonte, Minas Gerais, and included 85 patients who underwent 493 TPE sessions between April 2021 and December 2023. The median age was 43 years, and 60% of the patients were women. The most common indications for TPE were neuromyelitis optica (24%) and acute rejection following kidney transplantation (21%). The replacement fluids used were primarily albumin (84%) and plasma frozen 24 h after phlebotomy (16%). Adverse events were reported in 5.88% of patients, including hypotension, vasovagal reflex, and one case of facial edema and urticaria. No procedure-related deaths were observed. TPE sessions were conducted in accordance with the guidelines of the ASFA, with 50% of procedures classified as Category I. There was no significant association between adverse events and patient diagnoses. The study demonstrated that TPE is effective and safe, with predominant indications for neuromyelitis optica and kidney transplant rejection, following ASFA guidelines. Adverse events were rare and manageable.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"40 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Incidence Rate of Therapeutic Apheresis: Analysis of a Therapeutic Apheresis Database to Use as a Benchmarking Tool 治疗性血液分离的发生率:分析治疗性血液分离数据库作为基准工具
IF 1.4 4区 医学
Journal of Clinical Apheresis Pub Date : 2025-04-14 DOI: 10.1002/jca.70024
Joan Cid, Eva Rodríguez, Sandra Ortega, Anna M. Garcia, Jordi Comas, Paola Charry, Miquel Lozano, Rosa Ramos
{"title":"Incidence Rate of Therapeutic Apheresis: Analysis of a Therapeutic Apheresis Database to Use as a Benchmarking Tool","authors":"Joan Cid,&nbsp;Eva Rodríguez,&nbsp;Sandra Ortega,&nbsp;Anna M. Garcia,&nbsp;Jordi Comas,&nbsp;Paola Charry,&nbsp;Miquel Lozano,&nbsp;Rosa Ramos","doi":"10.1002/jca.70024","DOIUrl":"https://doi.org/10.1002/jca.70024","url":null,"abstract":"<div>\u0000 \u0000 <p>Benchmarking in apheresis medicine focuses on the collection of hematopoietic cells, where specific key performance indicators have been recommended to be used as an internal quality control of processes. The aim of this study was to collect data regarding the number of therapeutic apheresis procedures performed in Catalonia, Spain, and to compare this data with those from other countries. A database was created to collect therapeutic apheresis procedures from 2019 to 2023 in Catalonia, Spain. Similar articles about this topic were obtained using Medical Subject Headings in PubMed. To compare therapeutic apheresis performance among countries, the incidence rate of therapeutic apheresis was calculated as the number of therapeutic apheresis procedures per 1000 people per year. In a 5-year period, 26 897 therapeutic apheresis were performed in a 7.6 million population with an incidence rate of therapeutic apheresis of 0.71 per 1000 people per year. The incidence rate varied by as much as 10.1 times among the studies, from 0.07 in a USA study to 0.71 in the present study. When only European studies were compared, the incidence rate varied by as much as 1.65 times among the studies, from 0.43 in a Norwegian study to 0.71 in the present study. We report for the first time the therapeutic apheresis activity performed in Catalonia, Spain. Moreover, the incidence rate of therapeutic apheresis, calculated as the number of therapeutic apheresis procedures performed per 1000 people per year, is an objective indicator, easy to calculate, that can help in benchmarking therapeutic apheresis utilization.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"40 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Combined Treatment With Lipoprotein Apheresis and Hemodialysis in Patients With Severe Cardiovascular Disease, High Lipoprotein(a) and End Stage Renal Disease 脂蛋白分离和血液透析联合治疗严重心血管疾病、高脂蛋白(a)和终末期肾病患者
IF 1.4 4区 医学
Journal of Clinical Apheresis Pub Date : 2025-04-11 DOI: 10.1002/jca.70020
Tilmann Röseler, Daniel Kayser, Georg Schlieper, Wanja M. Bernhardt
{"title":"Combined Treatment With Lipoprotein Apheresis and Hemodialysis in Patients With Severe Cardiovascular Disease, High Lipoprotein(a) and End Stage Renal Disease","authors":"Tilmann Röseler,&nbsp;Daniel Kayser,&nbsp;Georg Schlieper,&nbsp;Wanja M. Bernhardt","doi":"10.1002/jca.70020","DOIUrl":"https://doi.org/10.1002/jca.70020","url":null,"abstract":"<p>Elevated Lipoprotein(a) (Lp(a)) is a known independent cardiovascular risk factor. Lp(a) Lipoprotein Apheresis (LA) substantially reduces the number of cardiovascular events. The effect of LA treatment in hemodialysis (HD) patients remains unknown. Retrospective analysis of nine patients undergoing LA and HD. Cardiovascular risk factors and the efficacy of treatment were assessed. Adverse cardiac or vascular events (ACVE) were recorded. Median (range) years on HD were 4.2 (1.5 to 23.6) years and median years on LA were 4.0 (1.6 to 12.4) years. Before initiation of LA, median (range) Lp(a) level was 242.67 (164.0 to 400.10) nmol/L and mean LDL-C level (±SD) 2.49 (±1.14) mmol/L. Under treatment, mean acute reduction rates, comparing concentrations before and after LA sessions, were 64.15 (±5.45)% for Lp(a) and 57.26 (±7.93)% for LDL-C. Before initiation of LA, 14 ACVE occurred; after initiation, only 6 (57.2% reduction rate). In this small cohort, LA appears to be effective in reducing ACVE in patients on HD with elevated Lp(a) levels. Further studies are needed to evaluate the effect of LA on cardiovascular outcomes in dialysis patients.</p>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"40 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jca.70020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy and Safety of Double Plasma Molecular Adsorption System at Different Therapeutic Doses During Regional Citrate Anticoagulation: A Pilot Study 不同剂量双等离子体分子吸附系统在局部柠檬酸盐抗凝中的疗效和安全性:一项初步研究
IF 1.4 4区 医学
Journal of Clinical Apheresis Pub Date : 2025-04-10 DOI: 10.1002/jca.70019
Xiankun Sun, Yuan Zhao, Mingjin Dai, Fang Wang, Xinyu Chen, Zhongwei Zhang, Yuanji Ma, Ling Zhang, Yingying Yang
{"title":"Efficacy and Safety of Double Plasma Molecular Adsorption System at Different Therapeutic Doses During Regional Citrate Anticoagulation: A Pilot Study","authors":"Xiankun Sun,&nbsp;Yuan Zhao,&nbsp;Mingjin Dai,&nbsp;Fang Wang,&nbsp;Xinyu Chen,&nbsp;Zhongwei Zhang,&nbsp;Yuanji Ma,&nbsp;Ling Zhang,&nbsp;Yingying Yang","doi":"10.1002/jca.70019","DOIUrl":"https://doi.org/10.1002/jca.70019","url":null,"abstract":"<div>\u0000 \u0000 <p>This study aimed to assess the safety and therapeutic efficacy of increasing the dosage of the double plasma molecular adsorption system (DPMAS) in patients with liver failure during regional citrate anticoagulation (RCA). A prospective nonrandomized controlled trial was conducted. Three groups (3 L group, 4.5 L group, and 6 L group) of patients with liver failure receiving DPMAS treatment were created on the basis of various therapeutic plasma volumes. A total of 303 patients were included, with 110 in the 3 L group, 121 in the 4.5 L group, and 72 in the 6 L group. At the end of treatment, there was a statistically significant difference in the bilirubin clearance rate among the groups (<i>H</i> = 15.239, <i>p</i> &lt; 0.001). Pairwise comparisons revealed that only the difference in the bilirubin clearance rates between the 6 L group and the 3 L group was statistically significant (<i>p</i> &lt; 0.001). With the exception of base excess, no statistically significant differences were found between these three groups for any of the relevant laboratory indicators (<i>p</i> &gt; 0.05). The incidence of hypotension, hypocalcemia, acidosis, alkalosis, hypernatremia, hyperlactatemia, and allergic reactions did not differ significantly among these three groups (<i>p</i> &gt; 0.05). Furthermore, a statistically significant difference was found in clotting events among these three groups (<i>p</i> = 0.027), with a higher incidence observed in the 6 L group than in the 3 L group (<i>p</i> = 0.011). Increasing the therapeutic dose of RCA-DPMAS further removed bilirubin and did not increase the complications associated with citrate anticoagulation, but the coagulation risk is a concern.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"40 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy and Safety of Using Designed Auxiliary Lines in Standard CRRT Machines for DFPP Treatment 标准CRRT机使用设计辅助线治疗DFPP的有效性和安全性
IF 1.4 4区 医学
Journal of Clinical Apheresis Pub Date : 2025-04-07 DOI: 10.1002/jca.70021
Fang Wang, Li Lin, Xiankun Sun, Xue Tang, Zhiwen Chen, Ling Zhang
{"title":"Efficacy and Safety of Using Designed Auxiliary Lines in Standard CRRT Machines for DFPP Treatment","authors":"Fang Wang,&nbsp;Li Lin,&nbsp;Xiankun Sun,&nbsp;Xue Tang,&nbsp;Zhiwen Chen,&nbsp;Ling Zhang","doi":"10.1002/jca.70021","DOIUrl":"https://doi.org/10.1002/jca.70021","url":null,"abstract":"<div>\u0000 \u0000 <p>The demand for double-filtration plasmapheresis (DFPP) in clinical settings is growing steadily, yet the range and availability of specialized equipment designed to support DFPP are relatively limited. We aimed to assess the efficacy and safety of a designed auxiliary line for DFPP treatment using standard continuous renal replacement treatment (CRRT) machines. This prospective self-controlled study was conducted between May 2021 and April 2024. Patients who underwent DFPP treatment using both specialized DFPP machines and standard CRRT machines (using designed auxiliary line) were enrolled in the study. DFPP sessions were divided into the specialized DFPP machine group and the standard CRRT machine group. The rates of completed DFPP treatments, DFPP cost, circuit clotting, hypotension, anaphylaxis, hypocalcemia, and nurse operating time were compared. A total of 440 DFPP sessions were performed for 80 patients, with 330 (75.0%) sessions in the specialized DFPP machine group and 110 (25.0%) in the standard CRRT machine group. There were no statistically significant differences between the two groups in terms of the completed DFPP treatment rate (89.4% vs. 88.2%, <i>p</i> = 0.724), circuit clotting (8.2% vs. 7.3%, <i>p</i> = 0.760), anaphylaxis (12.7% vs. 11.8%, <i>p</i> = 0.803), hypotension (10.6% vs. 9.1%, <i>p</i> = 0.650), hypocalcemia (17.3% vs. 20.0%, <i>p</i> = 0.519), and nurse operation time (35.08 ± 2.27 min vs. 36.62 ± 1.94 min, <i>p</i> = 0.082). However, the cost per DFPP session in the standard CRRT machine group was lower than in the specialized DFPP machine (976.81 ± 14.38 $ vs. 1007.43 ± 35.30 $, <i>p</i> &lt; 0.001). Standard CRRT machines can effectively and safely perform DFPP treatment using a specially designed auxiliary line, which is more cost-effective. Even in primary hospitals without specialized DFPP machines, CRRT machines can be used to perform DFPP treatment.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"40 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143786779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信