Transfusion and Apheresis Science最新文献

{"title":"Impact of hyperbaric oxygen on post-UCB transplant blood transfusion and growth factor support","authors":"Haitham Abdelhakim ,&nbsp;Ahmed Hebishy ,&nbsp;Leyla Shune ,&nbsp;Joseph McGuirk ,&nbsp;Andrea Baran ,&nbsp;Dennis Allin ,&nbsp;Alain Mina ,&nbsp;Omar S. Aljitawi","doi":"10.1016/j.transci.2025.104176","DOIUrl":"10.1016/j.transci.2025.104176","url":null,"abstract":"<div><h3>Objectives</h3><div>This study seeks to evaluate time to packed red blood cell (PRBC) and platelet independence and growth factor use for the HBO study population in comparison to historic UCB transplant data from the same institution.</div></div><div><h3>Background</h3><div>Umbilical cord blood (UCB) transplantation is limited by low stem/progenitor cell numbers and impaired homing, causing delayed engraftment and higher rates of engraftment failure, which increase post-transplant transfusion needs. Hyperbaric oxygen (HBO) therapy has shown to improve engraftment and blood count recovery in animal models and initial human trials.</div></div><div><h3>Methods/materials</h3><div>Fifteen subjects underwent HBO therapy at the Univrsity of Kansas Cancer Center (KUCC) after reduced intensity conditioning (RIC) or myeloablative conditioning (MAC) regimens in preparation for UCB transplantation. Six hours following HBO therapy, they received single or double UCB units. Patient records were reviewed for post-transplant PRBC and platelet transfusion requirements and for growth factor use. One HBO patient was excluded from this analysis due to graft rejection and autologous recovery. These were compared to standard UCB recipient requirements from previous KUCC patients.</div></div><div><h3>Results</h3><div>In the first 100 days post-transplant, HBO patients required fewer consecutive days of G-CSF support and achieved PRBC and platelet independence significantly faster than standard group patients. By days 66 and 74, 100 % of HBO patients were PRBC and platelet independent, respectively, compared to 67.4 % and 65.1 % in the standard group by day 100.</div></div><div><h3>Conclusion</h3><div>HBO-therapy may offer a potential improvement in growth factor support and TTI in adult patients undergoing UCB transplantation.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"64 4","pages":"Article 104176"},"PeriodicalIF":1.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322408","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}

{"title":"Combined use of Carfilzomib and plasmapheresis in antibody-mediated liver transplant rejection","authors":"Yaseen Ali Jamal,&nbsp;Junaid Wali,&nbsp;Christopher Shin,&nbsp;Mrigender Singh Virk,&nbsp;Melody Zhang,&nbsp;Muharrem Yunce","doi":"10.1016/j.transci.2025.104175","DOIUrl":"10.1016/j.transci.2025.104175","url":null,"abstract":"<div><div>Antibody-mediated rejection (AMR) poses significant challenges in liver transplant patients, and treatment guidelines recommend variable approaches which usually combine therapeutic plasma exchange (TPE) with immunosuppression therapies without standardized protocols <span><span>[1]</span></span>. Here we report two patients with AMR post-liver transplant refractory to multiple treatment regimens who were consequently treated with a combination of Carfilzomib and TPE. Patient 1 was treated within two months after transplant and demonstrated significant clinical improvement, normalization of liver function tests (LFTs) and bilirubin, and reduction in donor-specific antibody (DSA) levels following Carfilzomib and TPE. Conversely, Patient 2 was treated more than seven months after the transplant and additionally suffered from chronic cellular rejection with intermittent adherence to outpatient immunosuppressive medications; although DSA levels were marginally reduced following Carfilzomib and TPE, the patient showed minimal clinical improvement, ultimately necessitating a repeat transplant. Overall, Case #1 suggests that Carfilzomib combined with TPE can improve outcomes in select patients especially who have early AMR, while Case #2 highlights critical complicating factors including concomitant disease processes and immunosuppression, thus emphasizing the need for personalizing treatment strategies based on clinical presentation.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"64 4","pages":"Article 104175"},"PeriodicalIF":1.4,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280120","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}

{"title":"Relapse and beyond: Navigating the long-term clinical impacts of immune thrombotic thrombocytopenic purpura","authors":"Minh-Ha Tran ,&nbsp;Jennifer Jones ,&nbsp;Jesse Qiao","doi":"10.1016/j.transci.2025.104174","DOIUrl":"10.1016/j.transci.2025.104174","url":null,"abstract":"<div><div>Immune Thrombotic thrombocytopenic purpura (iTTP) is a rare but life-threatening thrombotic microangiopathy characterized by an autoantibody against ADAMTS13, leading to accumulation of ultra-large von Willebrand multimers, systemic platelet microthrombi, end-organ damage, and mortality if untreated. Therapeutic plasma exchange and corticosteroids have been the mainstay therapy for decades, but there exists significant relapse potential after the initial acute episode. While more recent advances in the use of immunotherapy (e.g. rituximab and caplacizumab) have significantly improved acute survival and short-term exacerbation/relapse prevention, long-term complications of the disease remain a concern for survivors. This narrative review discusses challenges of optimizing post-remission care after iTTP, highlighting disease impact on neurological, cardiovascular, and psychological health. Chronic cognitive impairment, increased risk of hypertension and ischemic events, and mental health challenges such as anxiety and depression are reported in iTTP survivors. Moreover, recurrence risk and persistent ADAMTS13 deficiency may define the need for long-term monitoring and individualized treatment of potential relapse. We emphasize the importance of multidisciplinary, patient-centered management, not only in the management and prevention of iTTP relapse episodes, but to improve quality of life and reduce morbidity in survivors of this rare disease. Providers should possess heightened awareness of long-term complications and atypical manifestations of relapse in survivors. We advocate for further research and observational cohort studies to formulate standardized guidelines for surveillance and intervention to mitigate the chronic burden of iTTP.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"64 4","pages":"Article 104174"},"PeriodicalIF":1.4,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255298","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}

{"title":"Rare case of tacrolimus-induced immune hemolytic anemia in a child after liver transplantation","authors":"Bowei Cao,&nbsp;Yanhong Bu,&nbsp;Yongjun Wang,&nbsp;Ningjie Zhang","doi":"10.1016/j.transci.2025.104172","DOIUrl":"10.1016/j.transci.2025.104172","url":null,"abstract":"<div><div>Tacrolimus (FK506), a macrolide antibiotic derived from actinomycete fermentation products, has emerged as the primary clinical anti-rejection drug. Previous studies have shown that patients frequently encounter adverse effects, such as infections, hypertension, diabetes mellitus, hepatic impairment, and renal impairment. However, few occurrences of immune hemolytic anemia caused by tacrolimus have been reported. We present a patient with drug-induced immune hemolytic anemia caused by oral tacrolimus after liver transplantation. The patient's direct antiglobulin test is strongly positive(IgG type), with both serum antibody screening and red blood cell eluate antibody screening positive. Furthermore, the crossmatches in the anti-human globulin gel are incompatible. The manual polybrene method employed in the antibody screening and crossmatching tests eliminates interference from tacrolimus.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"64 4","pages":"Article 104172"},"PeriodicalIF":1.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241786","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}

{"title":"When should I use filgrastim after autologous transplantation in MM patients?","authors":"Süleyman Arslan ,&nbsp;Ilhami Berber ,&nbsp;Irfan Kuku ,&nbsp;Emin Kaya ,&nbsp;Mehmet Ali Erkurt ,&nbsp;Soykan Biçim ,&nbsp;Ahmet Kaya ,&nbsp;Abdulvahap Pinar","doi":"10.1016/j.transci.2025.104171","DOIUrl":"10.1016/j.transci.2025.104171","url":null,"abstract":"<div><h3>Background</h3><div>Granulocyte colony-stimulating factor (G-CSF) is routinely administered following autologous stem cell transplantation in patients with multiple myeloma (MM); however, the optimal timing for its initiation remains unclear. While previous studies have evaluated heterogeneous patient cohorts, including those with MM, Non-Hodgkin’s Lymphoma, and Hodgkin’s Lymphoma, this study focuses exclusively on MM patients. We aimed to compare the outcomes of initiating G-CSF either on day + 1 post-transplantation or upon the onset of neutropenia, with particular emphasis on neutrophil and platelet engraftment times, to help define an optimal G-CSF administration strategy in this patient population.</div></div><div><h3>Study Design and Methods</h3><div>This retrospective study included 122 MM patients who underwent autologous hematopoietic stem cell transplantation between 2016 and 2022 at the Hematology Clinic of İnönü University Turgut Özal Medical Center. Patients were evenly divided into two groups. In Group 1, filgrastim was initiated on day + 1 post-transplantation, while in Group 2, it was administered after the onset of neutropenia. Neutrophil and platelet engraftment times, as well as antibiotic usage, were compared between the groups.</div></div><div><h3>Results</h3><div>There were no statistically significant differences in neutrophil or platelet engraftment times or in antibiotic usage between the two groups (p &gt; 0.05). The median neutrophil and platelet engraftment times were 14 and 15 days, respectively, in the day + 1 group, and 15 and 14 days in the neutropenia-guided group. However, the median number of filgrastim injections was significantly lower in the neutropenia group (8 injections, range: 6–12) compared to the day + 1 group (14 injections, range: 8–24) (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Initiating G-CSF upon the development of neutropenia is as effective as early (day +1) administration in MM patients undergoing autologous transplantation. This delayed strategy does not adversely affect engraftment or antibiotic requirements and significantly reduces the number of G-CSF injections, offering potential benefits in terms of cost-effectiveness and reduced side effects.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"64 4","pages":"Article 104171"},"PeriodicalIF":1.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263821","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}

{"title":"Incidence and predictors of hospital acquired anemia in COVID-19 ARDS patients hospitalized in intensive care unit","authors":"Büşra Tezcan ,&nbsp;Behiye Deniz Kosovalı ,&nbsp;Müçteba Can ,&nbsp;Ali Eba Demirbağ ,&nbsp;Asiye Yavuz ,&nbsp;Nevzat Mehmet Mutlu","doi":"10.1016/j.transci.2025.104173","DOIUrl":"10.1016/j.transci.2025.104173","url":null,"abstract":"<div><h3>Aim</h3><div>Hospital acquired anemia (HAA) can be defined as a new-onset anemia in hospitalized patients who have a normal hemoglobin concentration at admission. It is one of the most common comorbidities with multifactorial causes in intensive care units (ICU) worldwide. The aim of our study was to investigate the incidence and predictors of HAA, as well as its relationship with mortality, in COVID-19 ARDS patients admitted to ICU.</div></div><div><h3>Methods</h3><div>All adult COVID-19 ARDS patients admitted to our 48-bed medical ICU between from January 2020 to December 2021 (n = 1007) were analyzed. HAA was defined as a nadir Hgb value during the course of ICU stay meeting WHO criteria. Anemia was further classified into mild, moderate and severe anemia. Patients who did not develop HAA were compared with those who develop HAA as well as with categories of HAA severity. The factors which can predict HAA and severe HAA were also analyzed.</div></div><div><h3>Results</h3><div>Among 545 ARDS patients without anemia at admission, 373 (68.4 %) developed HAA. The majority of HAA cases were mild (168, 45.0 %), whereas 127 (34.1 %) had moderate and 78 (20.9 %) had severe anemia. The risk of mortality progressively increased with increasing degree of HAA. Admission hemoglobin levels and length of ICU stay are predictive of the development of both HAA and severe HAA; while neurologic comorbidities and requirement of hemodialysis are predictive of development of severe HAA.</div></div><div><h3>Conclusion</h3><div>HAA is common in COVID-19 ARDS patients. Awareness should be raised to prevent the development of HAA in ICUs, especially in patients with relatively low admission hemoglobin levels, neurologic comorbidities, longer ICU stays and patients who undergo hemodialysis treatment.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"64 4","pages":"Article 104173"},"PeriodicalIF":1.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241785","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}

{"title":"Efficiency and safety of granulocyte colony-stimulating factor combined with plerixafor for autologous peripheral blood hematopoietic stem cell mobilization in light chain amyloidosis","authors":"Mengnan Liu,&nbsp;Wencui Chen,&nbsp;Jinzhou Guo,&nbsp;Xiaomei Wu,&nbsp;Xianghua Huang","doi":"10.1016/j.transci.2025.104130","DOIUrl":"10.1016/j.transci.2025.104130","url":null,"abstract":"<div><div>Autologous stem cell transplantation (ASCT) is one of the standard treatments for light chain (AL) amyloidosis, and the mobilization of peripheral blood hematopoietic stem cell (PBHSC) is crucial for transplantation. Plerixafor has been shown to promote stem cell mobilization. The retrospective study included 56 patients who underwent ASCT. Twenty-eight patients received G-CSF combined with plerixafor (G+P), and the other 28 patients received G-CSF based stem cell mobilization (G). All patients finally achieved the minimum collection requirements, but there was no statistical difference in the total CD34 + cells yield between the two groups (<em>p</em> = 0.74). The number of patients achieving the minimum goal, peripheral blood CD34 + cells count, product CD34 + cells count, and CD34 + cells yield of the first apheresis day were higher in the group G+P compared with the group G (28 vs 21, <em>p</em> = 0.02; 106 cells/μL vs 38 cells/μL, <em>p</em> &lt; 0.01; 1880 cells/μL vs 936 cells/μL, <em>p</em> &lt; 0.01; 5.6 × 10⁶ cells/kg vs 3.3 × 10⁶ cells/kg, <em>p</em> &lt; 0.01). All perimobilization adverse events were grade 1–2 and no mortality was observed. In conclusion, G-CSF combined with plerixafor mobilization is effective and safe in patients with AL amyloidosis.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"64 3","pages":"Article 104130"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221002","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}

{"title":"Adverse events during preoperative autologous blood donation and its usage in obstetrical patients: A multicenter, retrospective survey in Japan","authors":"Akihiko Yokohama ,&nbsp;Hiroshi Fujita ,&nbsp;Kazuhiro Nagai ,&nbsp;Shin-ichiro Fujiwara ,&nbsp;Kazuki Tanimoto ,&nbsp;Takashi Ushiki ,&nbsp;Tomoko Henzan ,&nbsp;Yoshihiro Hatta ,&nbsp;Ryu Yanagisawa ,&nbsp;Kazuaki Watanabe ,&nbsp;Jun Murakami ,&nbsp;Yuichi Hasegawa ,&nbsp;Kazuhiko Ikeda ,&nbsp;Keizo Fujino ,&nbsp;Mayumi Matsumoto ,&nbsp;Asashi Tanaka ,&nbsp;Shigeyoshi Makino ,&nbsp;Shuichi Kino ,&nbsp;Akihiro Takeshita ,&nbsp;Kazuo Muroi","doi":"10.1016/j.transci.2025.104131","DOIUrl":"10.1016/j.transci.2025.104131","url":null,"abstract":"<div><h3>Background</h3><div>Evaluating the safety of preoperative autologous blood donation (PAD) and its transfusion is important, especially for young pregnant donors in an era of extremely low incidence of viral transmission.</div></div><div><h3>Materials and Methods</h3><div>Questionnaires were sent to hospitals, and safety information from donation to transfusion was collected and analyzed.</div></div><div><h3>Results</h3><div>Among 2378 obstetrical donors who underwent PAD, 1664 received autologous blood only (autologous group), 146 received allogeneic blood in addition to autologous blood (allogeneic group), and 568 received no transfusion (no transfusion group). Two hundred one of the 2378 patients (8.5 %) experienced adverse events (AEs) during PAD and its transfusion, although most AEs were mild. Even in the no-transfusion group, 8.1 % of patients experienced some AEs. The vasovagal reaction (VVR) rate was 2.6 % (n = 63). Other AE associated with donation developed in 114 patients (4.8 %), and they were the main components of all AEs; 32.5 % of them were unique to obstetric patients. Obstetrical donors with PAD may have disadvantages compared to donors with PAD in other settings. Transfusion reactions (TRs) occurred in 29 (1.2 %) patients. Surprisingly, the number of patients with TRs per unit did not differ significantly between the autologous and allogeneic groups.</div></div><div><h3>Conclusion</h3><div>Considering that most AEs occurred due to donation, PAD in obstetric patients was not beneficial. Moreover, similar TRs rates between the autologous and allogeneic groups did not indicate the priority of autologous blood. PAD should be performed by using a well-established transfusion management system.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"64 3","pages":"Article 104131"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221003","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}

{"title":"Comparison of the efficacy and total cost of peripheral blood stem cell collections in allogeneic donors using either filgrastim (Neupogen®) or filgrastim aafi (Nivestym®)","authors":"Chuying Su ,&nbsp;Leon L. Su ,&nbsp;Kristin L. Gray ,&nbsp;Carrie E. Karlene ,&nbsp;Theresa N. Kinard ,&nbsp;Lance A. Williams III","doi":"10.1016/j.transci.2025.104113","DOIUrl":"10.1016/j.transci.2025.104113","url":null,"abstract":"<div><div>This retrospective study evaluated the efficacy and total cost of switching from filgrastim (Neupogen) to its biosimilar, filgrastim-aafi (Nivestym), for allogeneic peripheral blood stem cell collection (PBSCC). Among 127 donors, Nivestym and Neupogen showed comparable mobilization outcomes, achieving similar CD34 + cell counts and one-day collection success rates for ≥ 2.0 × 10⁶ and ≥ 4.0 × 10⁶ CD34 + cells/kg recipient weight. Nivestym offered significant reduction in total cost, with an average of $5171.92 versus $6288.76 (p &lt; 0.0001). These findings support Nivestym as a viable alternative, highlighting the importance of evaluating both clinical outcomes and financial implications for biosimilar adoption.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"64 3","pages":"Article 104113"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221000","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}

{"title":"Plasmapheresis can improve clinical outcomes in patients with therapy resistant benign recurrent intrahepatic cholestasis: A case report","authors":"Eiman A. Hussein","doi":"10.1016/j.transci.2025.104126","DOIUrl":"10.1016/j.transci.2025.104126","url":null,"abstract":"<div><h3>Background</h3><div>Due to the rarity of benign recurrent intrahepatic cholestasis (BRIC), limited literature exists regarding the therapeutic benefit of plasmapheresis, particularly in the context of severe hyperbilirubinemia.</div></div><div><h3>Case report</h3><div>A 25-year-old female presented with jaundice and severe pruritus. Laboratory findings revealed a total bilirubin of 37 mg/dL and a direct bilirubin of 27 mg/dL. Alanine aminotransferase (ALT) was 31 U/L, aspartate aminotransferase (AST) was 35 U/L, and alkaline phosphatase was 175 U/L. The patient had a five-year history of recurrent episodes, previously resolving spontaneously or with medical treatment. Following liver biopsy diagnosis and failure of conventional therapy, she underwent plasmapheresis on alternate days. Four sessions of one plasma volume exchange, using albumin, were performed concurrently with medical treatment. The patient demonstrated rapid and significant improvement in pruritus and urine color, with no adverse events or need for fresh frozen plasma. Total bilirubin decreased progressively to 5 mg/dL, and direct bilirubin to 4 mg/dL.</div></div><div><h3>Conclusion</h3><div>Plasmapheresis appears to be a beneficial adjunct therapy for refractory BRIC, effectively reducing bilirubin levels and alleviating pruritus. This intervention may improve patient quality of life and potentially prevent renal complications associated with hyperbilirubinemia, serving as a bridge to liver transplantation, if necessary.</div></div>","PeriodicalId":49422,"journal":{"name":"Transfusion and Apheresis Science","volume":"64 3","pages":"Article 104126"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221001","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}