Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy最新文献

{"title":"Combined FMEA and Cause-Effect Analysis Method for Risk Assessment of Failures Impacting Hemodialysis Water Quality.","authors":"Belchkar Salim, Oumokhtar Bouchra, Benboubker Moussa, Mammate Naima, Rossi Manal, El Bardai Ghita, Basmat Amal Chouhani, Sqalli Houssaini Tarik","doi":"10.1002/1744-9987.70200","DOIUrl":"https://doi.org/10.1002/1744-9987.70200","url":null,"abstract":"<p><strong>Introduction: </strong>Hemodialysis patients are exposed weekly to large volumes of dialysis water, making water quality a critical determinant of patient safety. Failures in dialysis water treatment systems may lead to chemical contamination, microbiological proliferation, endotoxin exposure, and biofilm formation, resulting in severe clinical complications. Despite the importance of risk prevention, few studies have applied failure mode and effects analysis (FMEA) to assess risks associated with hemodialysis water treatment. This study aimed to evaluate potential failures affecting dialysis water quality using a combined FMEA and cause-effect analysis approach.</p><p><strong>Methods: </strong>A multidisciplinary risk assessment was conducted at the hemodialysis water treatment unit of Hassan II University Hospital in Fez, Morocco. The production chain was divided into four subprocesses: water feeding, pretreatment, treatment, and distribution. Potential failures, causes, and effects were identified through brainstorming sessions and root-cause analysis using an Ishikawa diagram. Each failure mode was scored according to frequency (F), severity (S), detectability (D), and management (M) using predefined five-level ordinal scales. Two indicators were calculated: the classical risk priority number (RPN1 = F × S × D) and a complementary management-adjusted indicator (RPN2 = (F × S)/M).</p><p><strong>Results: </strong>Thirty-nine failure modes were identified across the dialysis water production process. Root causes were classified into three categories: Method and procedure, material and equipment, and physical and environmental factors. Based on classical RPN stratification, 30 failure modes were categorized as low priority, 8 as intermediate priority, and 1 as high priority. The highest-risk failure was a drop in water flow within the pretreatment circuit (RPN1 = 80). Intermediate-priority failures mainly involved alarm malfunctions, reverse osmosis maintenance issues, hydraulic disturbances, inadequate sampling, and temperature instability. The management-adjusted analysis highlighted electrical interruption of the water treatment unit as the failure mode with the greatest control-related concern (RPN2 = 15).</p><p><strong>Conclusion: </strong>The combined FMEA and cause-effect analysis effectively identified vulnerabilities affecting hemodialysis water quality and supported prioritization of corrective actions. The approach provides a practical framework for improving dialysis water safety and may be integrated into routine quality management practices, particularly in resource-limited healthcare settings.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity as a Potential Contributor to Early Femoral Tunneled Dialysis Catheter Failure: A Clinical Observation.","authors":"Thotanolla Surya Prakash","doi":"10.1002/1744-9987.70218","DOIUrl":"https://doi.org/10.1002/1744-9987.70218","url":null,"abstract":"","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpreting COVID-19 Fear and Health Literacy in Hemodialysis After Vaccine Roll-Out.","authors":"Dongjie Yan, Hongyu Chen","doi":"10.1002/1744-9987.70214","DOIUrl":"https://doi.org/10.1002/1744-9987.70214","url":null,"abstract":"","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cell-Free and Concentrated Ascites Reinfusion Therapy for Refractory Ascites Following Pediatric Liver Transplantation.","authors":"Itsuki Naya, Naoya Yamada, Yoshihiro Hirata, Yoshiyuki Ihara, Megumi Tamura, Motoki Ebihara, Shoichi Tsuzaka, Rina Matsuda, Shotaro Taki, Shoko Ogawa, Kyoichi Deie, Hiroshi Kawashima, Koichi Mizuta","doi":"10.1002/1744-9987.70215","DOIUrl":"https://doi.org/10.1002/1744-9987.70215","url":null,"abstract":"<p><strong>Introduction: </strong>Cell-free and concentrated ascites reinfusion therapy (CART) has been widely used for malignant ascites and decompensated cirrhosis, but its perioperative application remains unclear. We evaluated CART after pediatric living donor liver transplantation (LDLT).</p><p><strong>Methods: </strong>We retrospectively reviewed pediatric LDLT recipients who underwent CART for refractory ascites. Changes in ascites volume, protein recovery rates including albumin and immunoglobulin G (IgG), and adverse events were analyzed.</p><p><strong>Results: </strong>Ten recipients underwent 92 CART sessions. Median ascites volume decreased from 1785 mL to 362 mL after concentration. Median recovery rates were 70.1% for total protein, 71.8% for albumin, 72.0% for IgG, 76.2% for antithrombin III, and 109.4% for coagulation factor XIII. Larger ascites volumes were weakly associated with higher recovery efficiency. No serious adverse events occurred.</p><p><strong>Conclusions: </strong>CART may be a safe and useful option for managing refractory ascites and protein recovery after pediatric LT while minimizing reinfusion volume.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Series: Management of Elevated Lipoprotein(a) by Double-Filtration Plasmapheresis in Hemodialysis Patients With Chronic Kidney Disease.","authors":"Zead Tubail, Christophe Goetz, Benjamin Savenkoff, Nadia Ouamara","doi":"10.1002/1744-9987.70213","DOIUrl":"10.1002/1744-9987.70213","url":null,"abstract":"<p><strong>Background: </strong>Elevated lipoprotein(a) (Lp(a)) is a recognized independent cardiovascular risk factor, particularly in patients with chronic kidney disease (CKD) undergoing hemodialysis, for whom pharmacological treatment options remain limited. Lipoprotein apheresis with double-filtration plasmapheresis (DFPP) is a semiselective apheresis technique associated with reductions in serum Lp(a) levels.</p><p><strong>Objective: </strong>To describe the clinical and biological outcomes of lipoprotein apheresis with DFPP in five hemodialysis patients with markedly elevated Lp(a) levels (> 200 nmol/L) and a history of cardiovascular disease (CVD).</p><p><strong>Methods: </strong>We report a case series of five CKD patients undergoing hemodialysis who underwent lipoprotein apheresis with DFPP, either concomitantly with hemodialysis or separately depending on hemodynamic tolerance. Biological parameters, including Lp(a), low-density lipoprotein (LDL) cholesterol, triglycerides, fibrinogen, blood pressure, and session characteristics (plasma volume treated and session duration), were assessed before and after lipoprotein apheresis sessions with DFPP.</p><p><strong>Results: </strong>All patients experienced marked reductions in Lp(a), LDL cholesterol, triglycerides, and fibrinogen following lipoprotein apheresis sessions. The procedure was performed concomitantly with hemodialysis in four patients with stable hemodynamic parameters. In one patient, the procedure was carried out separately from hemodialysis because of hemodynamic intolerance.</p><p><strong>Conclusion: </strong>Lipoprotein apheresis with DFPP appeared effective in reducing elevated Lp(a) levels and was generally well tolerated in hemodialysis patients.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Double Filtration Plasmapheresis in Guillain-Barré Syndrome: A Single-Center Retrospective Study.","authors":"Jingwen Li, Ying Chen, Jun Wu, Yufang Mei, Liping Ni, Huiying Qiu, Yan Zhou, Ying Zhang, Wenbin Wan","doi":"10.1002/1744-9987.70211","DOIUrl":"https://doi.org/10.1002/1744-9987.70211","url":null,"abstract":"<p><strong>Background: </strong>Guillain-Barré syndrome (GBS) is an acute immune-mediated peripheral neuropathy for which therapeutic apheresis is an established treatment option. Various treatment modalities, including double filtration plasmapheresis (DFPP), are widely used in clinical practice; however, real-world data on their clinical outcomes and adjunctive treatment strategies remain limited.</p><p><strong>Methods: </strong>We retrospectively analyzed 43 patients with GBS treated at a single tertiary center between June 2018 and October 2024, including 36 patients who received DFPP-containing regimens and 7 who received IVIG alone. Short-term functional outcomes were assessed using the modified Rankin scale (mRS) and Hughes functional grading scale (HFGS) at hospital admission before treatment and after completion of inpatient treatment. Changes in immunoglobulin and complement levels were evaluated in patients receiving DFPP. Exploratory analyses compared functional score changes across different treatment regimens.</p><p><strong>Results: </strong>At hospital discharge, mRS and HFGS scores were significantly lower than baseline in patients receiving DFPP alone, DFPP combined with intravenous methylprednisolone, or IVIG alone. No significant differences in changes in functional scores were observed between the DFPP-alone and IVIG-alone groups or between the DFPP-alone and DFPP-plus-corticosteroid groups. DFPP significantly reduced serum immunoglobulin and complement levels; however, the percentage reductions in IgG, IgA, and IgM were not significantly correlated with short-term changes in mRS or HFGS scores.</p><p><strong>Conclusion: </strong>In this real-world cohort, DFPP-containing treatment was associated with short-term improvement in functional scores from hospital admission to hospital discharge. No statistically significant difference in short-term functional improvement was detected between the DFPP-alone and DFPP-plus-IVMP groups. However, the small sample size, heterogeneous treatment regimens, and lack of long-term follow-up preclude conclusions regarding sustained or comparative efficacy.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Plasma Exchange in Neuromyelitis Optica Spectrum Disorder: Real-World Clinical Outcomes and Safety From a Tertiary Care Center in Northwest India.","authors":"Alka Kumari, Sarita Sharma, Ajay Kumar, Sunita Bundas","doi":"10.1002/1744-9987.70212","DOIUrl":"https://doi.org/10.1002/1744-9987.70212","url":null,"abstract":"<p><strong>Background and objectives: </strong>Neuromyelitis Optica Spectrum Disorder (NMOSD) is a severe autoimmune demyelinating disorder of the central nervous system characterized by relapsing attacks that can result in permanent neurological disability. Therapeutic Plasma Exchange (TPE) is recommended for steroid-refractory acute exacerbations. This study evaluated the efficacy and safety of TPE in patients with acute NMOSD attacks.</p><p><strong>Materials and methods: </strong>A prospective observational study was conducted over 18 months at SMS Jaipur, India. Forty adult patients fulfilling the 2015 International Panel for NMO Diagnosis criteria and presenting with steroid-refractory acute attacks were enrolled. TPE was performed using continuous-flow centrifugation, exchanging 1.0-1.4 estimated plasma volumes per session for 3-7 alternate-day procedures. Clinical outcomes were assessed using the EDSS, Snellen visual acuity, and MRC muscle strength grading.</p><p><strong>Results: </strong>The cohort had a female predominance (65.0%) with a mean age of 36.5 years. Acute first presentations accounted for 77.5% of cases, while 22.5% were relapses. Anti-aquaporin-4 antibody positivity was detected in 45.0% of patients. Among 37 patients with motor deficits, 94.6% showed clinical improvement following TPE, including marked (35.1%), moderate (43.2%), and mild (16.2%) responses. Mean EDSS improved significantly from 7.4 to 4.1 (95% CI and p < 0.001). Visual improvement was observed in 84.4% of patients with baseline visual impairment. Adverse events occurred in 25.0% of patients, predominantly transient hypotension and mild citrate-related hypocalcemia, with no procedure-related treatment discontinuation.</p><p><strong>Conclusion: </strong>TPE is a safe and effective rescue therapy for steroid-refractory NMOSD exacerbations, producing substantial neurological and visual recovery with a favorable safety profile.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Clinical Outcomes of Circuit Clotting During Prolonged Polymyxin B Hemoperfusion in Patients With Septic Shock: A Post Hoc Analysis of a Prospective Cohort Study.","authors":"Kyohei Miyamoto, Yu Kawazoe, Takeshi Morimoto, Hitoshi Yamamura, Noriko Miyagawa, Yoshinori Ohta, Mami Shibata, Nozomu Shima, Tsuyoshi Nakashima, Shigeaki Inoue","doi":"10.1002/1744-9987.70210","DOIUrl":"https://doi.org/10.1002/1744-9987.70210","url":null,"abstract":"<p><strong>Introduction: </strong>Circuit clotting during polymyxin B hemoperfusion (PMX-HP) therapy could be associated with poor clinical outcomes in patients with septic shock.</p><p><strong>Methods: </strong>This post hoc sub-analysis of the BEAT-SHOCK registry included 82 of 309 adults with septic shock requiring high-dose norepinephrine (≥ 0.2 μg/kg/min) that underwent PMX-HP therapy. We compared 28-day mortality between patients with and without circuit clotting during the first session.</p><p><strong>Results: </strong>Among 82 patients (median PMX-HP duration, 1016 min), 25 patients (30%) had premature termination due to circuit clotting of those patients, 28-day mortality was 16% (4/25), as compared with 18% (10/57) in those without circuit clotting (adjusted hazard ratio 0.58; 95% confidence interval 0.13-2.55). Lower serum albumin was associated with circuit clotting (adjusted hazard ratio 0.48; 95% confidence interval 0.27-0.85; per 1 g/dL increase).</p><p><strong>Conclusions: </strong>Circuit clotting occurred in one-third of patients but was not associated with poorer outcomes.</p><p><strong>Trial registration: </strong>UMIN Clinical Trial Registry, registration no. UMIN000038302.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Evolution of Renal Dialysis Nursing Research: A CiteSpace-Driven Bibliometric Analysis of Knowledge Structures (1965-2025).","authors":"Qin Xiao, Wenjing Chang, Jing Yao, Na Zhao, Jing He","doi":"10.1002/1744-9987.70205","DOIUrl":"10.1002/1744-9987.70205","url":null,"abstract":"<p><strong>Background: </strong>Renal dialysis nursing is critical for improving survival and quality of life in patients with end-stage kidney disease (ESKD). This study systematically analyzed global research trends and frontiers in renal dialysis nursing from 1965 to 2025 using bibliometric methods.</p><p><strong>Methods: </strong>A total of 608 peer-reviewed articles published between 1965 and 2025 were retrieved from the Web of Science Core Collection. CiteSpace software was employed for co-occurrence analysis, keyword clustering, and burst detection based on data from 2002 to 2025 to ensure analytical robustness. Temporal trends were divided into three phases (1988-2002, 2003-2012, and 2013-2025), and core themes were identified through keyword co-occurrence networks.</p><p><strong>Discussion: </strong>Results revealed sustained growth in publications after 2003, peaking at 53 articles in 2015 and remaining at a high level through 2025. Core themes included social support systems, home dialysis, nurse-led case management, and nutritional risk assessment. Emerging frontiers focused on conservative management optimization, patient burden, and young adult care. The study highlights global shifts toward personalized, telemedicine-enabled care models and emphasizes the need for China to strengthen social support frameworks and remote care technologies.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Taking on the Editorship of Therapeutic Apheresis and Dialysis.","authors":"Takafumi Ito","doi":"10.1002/1744-9987.70209","DOIUrl":"10.1002/1744-9987.70209","url":null,"abstract":"","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}