Abstract:
BACKGROUND/AIMS:High-volume plasma exchange (HVPE), defined as an exchange of 8 to 12 L per day per procedure or 15% of the ideal body weight with fresh frozen plasma, has shown promising results in improving the survival of patients with acute liver failure (ALF). However, clinical evidence is limited. The aim of this study was to report our initial experience using HVPE as a bridge treatment in patients with ALF. METHODS:We retrospectively reviewed 32 consecutive patients awaiting liver transplantation (LT) due to ALF between 2013 and 2020 at Samsung Medical Center in Korea. HVPE has been used for patients with ALF since May 2016 at our institution. RESULTS:During the study period, 16 patients received HVPE. After HVPE, coagulopathies (INR, 4.46 [2.32-6.02] vs 1.48 [1.33-1.76], P < .05), total bilirubin (22.6 [9.1-26.4] vs 8.9 [5.6-11.3], P < .05), alanine aminotransferase (506 [341-1963] vs 120 [88-315], P < .05), and ammonia levels (130.6 [123.7-143.8] vs 98.2 [84.2-116.5], P < .05) were improved. Improvement in the hepatic encephalopathy grade was observed in four patients. Among 16 patients who received HVPE, 12 patients were bridged to LT, and three patients recovered spontaneously. The overall survival was 94% and 69%, respectively at 30 days in patients who received and did not receive HVPE (P = .068). Among 18 patients with high chronic liver failure-sequential organ failure assessment scores (≥13), the overall survival was significantly better for those who received HVPE than for those who did not (91% vs 29%, respectively, at 30 days, P < .05). CONCLUSIONS:Our initial clinical experience with HVPE suggests that HVPE can be a viable option in improving the outcomes of patients presenting with ALF.
journal_name
J Clin Apherjournal_title
Journal of clinical apheresisauthors
Kim JE,Chun S,Sinn DH,Kim NJ,Kim S,Kang W,Kim JM,Choi GS,Joh JW,Cho Ddoi
10.1002/jca.21873subject
Has Abstractpub_date
2021-01-05 00:00:00eissn
0733-2459issn
1098-1101pub_type
杂志文章abstract::Thrombotic thrombocytopenic purpura (TTP) is a condition caused by deficiency of ADAMTS13 resulting in accumulation of ultra large Von Willebrand factor multimers (ULVWF), leading to micro thrombi in multiple organs. The varying susceptibilities of blood group antigens to ADAMTS13 have been demonstrated. A and B antig...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20202
更新日期:2009-01-01 00:00:00
abstract::This is an attempt at comparing two cell separators for plateletpheresis, namely the Fresenius AS.TEC 204 and Haemonetics MCS 3p, at a tertiary care center in India. Donors who weighed between 55-75 kg, who had a hematocrit of 41-43%, and platelet counts of 250x10(3)-400x10(3)/microl were selected for the study. The c...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20108
更新日期:2007-02-01 00:00:00
abstract::In the United States, therapeutic plasma exchange (TPE) is both performed and requested by a wide range of services, often on an empiric basis (before a diagnosis is established). Whether empiric therapy is beneficial has not been established. Patients were identified from an electronic procedure log that included tho...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20059
更新日期:2005-12-01 00:00:00
abstract::Although rituximab (RTX) is a promising therapeutic agent for treating steroid-resistant nephrotic syndrome (SRNS) resistant to various immunosuppressive agents, some patients have shown resistance to RTX. We report the case of a patient with RTX-resistant nephrotic syndrome and SRNS who was successfully treated with ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21613
更新日期:2018-06-01 00:00:00
abstract::"Leukocyte-depleted" platelet concentrates (LD-SDPC) were prepared by cotton-wool and by polyester filtration of "leukocyte-poor" PC collected by the elutriation technique. The storage characteristics of LD-SDPC were comparable to those of the filtered pools of multiple donor platelet concentrates (LD-MDPC). However, ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920060304
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:Factors affecting progenitor cell mobilization in patients with non-Hodgkin's lymphoma (NHL) and Hodgkin's lymphoma (HL) are incompletely understood. The aim of this retrospective study was to determine which factors are crucial for effective mobilization and collection of autologous peripheral blood stem ce...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21204
更新日期:2012-01-01 00:00:00
abstract::A patient with a hyper-IgE syndrome was treated with 60 plasmaphereses over a period of 2 years in conjunction with cytotoxic immunosuppressive drug therapy. During this time her severe dermatitis of 8 years' duration became almost completely inactive, and her circulating IgE level was reduced by 73%. An elevated pret...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920040104
更新日期:1988-01-01 00:00:00
abstract::Sickle cell disease (SCD) patients are prone to develop complications that include stroke, acute chest syndrome, and other crises. Some of these complications require chronic transfusion therapy or red cell exchange (RCE), either for therapeutic or prophylactic reasons. Due to a discrepancy of red cell antigens betwee...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,评审
doi:10.1002/jca.20112
更新日期:2006-12-01 00:00:00
abstract::The influence of 6 weeks of cyclosporin A (CYA), followed by a further 6 weeks of this agent in combination with plasma exchange (PE), was defined on panel reactivity and titre of preformed cytotoxic antibodies in stable patients on haemodialysis awaiting renal transplantation. Nine individuals with antibodies to 30% ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920060107
更新日期:1991-01-01 00:00:00
abstract::This study examined the incidence and predictors of peripheral blood stem cell (PBSC) mobilization failure in patients with multiple myeloma (MM). Retrospective data for 104 patients who received granulocyte colony-stimulating factor (G-CSF) alone or with cyclophosphamide as mobilization regimens were analyzed. The ra...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21326
更新日期:2014-12-01 00:00:00
abstract::Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disease treated successfully with plasma exchange. Jehovah's Witnesses whose religious beliefs preclude them from accepting plasma exchange may require alternative forms of therapy. We report a case of one such patient who presented with TTP, whom we succ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20150
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Autologous stem cell transplantation (auto-SCT) is a treatment approach in non-Hodgkin lymphoma (NHL) patients. The options for mobilization of CD34+ cells to support high-dose therapy are granulocyte-colony stimulating factors (G-CSFs) alone or after chemotherapy. Limited data exist on the efficacy of lipeg...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21785
更新日期:2020-08-01 00:00:00
abstract::Thrombopoietin (TPO) serum levels in 14 patients (9 male and 5 female, mean age 36 years, range 16 to 55 years) with breast cancer (n = 5), testicular cancer (n = 7), or lymphoma (n = 2), undergoing high dose chemotherapy with peripheral blood stem cell (PBSC) transplantation, were evaluated at the first day of the mo...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/(sici)1098-1101(1999)14:2<57::aid-jca2>3.0
更新日期:1999-01-01 00:00:00
abstract::Excess free iodide in the blood (ingested or injected) may cause thyrotoxicosis in patients at risk. Iodinated contrast solutions contain small amounts of free iodide and may be of significance for patients affected by Graves' disease, multinodular goiter or living in areas of iodine deficiency. Herein, we report a 57...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20161
更新日期:2008-01-01 00:00:00
abstract::The supply of deceased donor kidneys is inadequate to meet demand. To expand the pool of potential donors, ABO-incompatible transplants from living donors have been performed. We present the Mayo Clinic experience with such transplants. Enrollment was open to patients when the only available potential living kidney do...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20002
更新日期:2004-01-01 00:00:00
abstract::Because the administration of hematopoietic growth factors and the use of stem cell support often fails to alleviate the neutropenic phase induced by cytotoxic drugs, several investigators have attempted to expand ex vivo hematopoietic progenitors for clinical use. These attempts have clearly shown that the cultured c...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.10012
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Therapeutic plasma exchange (TPE) may remove medications from the patient's plasma. Data is limited on the effect of TPE on unfractionated heparin (UFH). STUDY DESIGN AND METHODS:A retrospective review was performed of patients receiving TPE and continuous IV infusion UFH from 1/1/2008 to 6/30/2010. TPE wit...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21441
更新日期:2016-12-01 00:00:00
abstract::Blood products are frequently required immediately prior to, during, or just after an apheresis procedure. Transfusion-related acute lung injury (TRALI) is now the leading cause of transfusion-related mortality, surpassing ABO-incompatible hemolytic reactions. The reported incidence of TRALI varies but is estimated at...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20158
更新日期:2008-01-01 00:00:00
abstract::Plasma replacement for thrombotic thrombocytopenic purpura (TTP) is accomplished with various plasma products. This study sought to determine the incidence of allergic reactions with FFP or CPP as replacement in therapeutic plasma exchange (TPE). Forty-one TTP patients were identified retrospectively who received TPE ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.1025
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Hyperleukocytosis is commonly seen in acute and chronic leukemias. Therapeutic leukocytapheresis using an automatic cell separator can help to achieve prompt leukoreduction to reduce the rate of thrombotic events and early mortality as well as to prevent tumor lysis syndrome. AIM:In this study, we report a ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21766
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Autoimmune disorders and neurodegenerative disorders take a physical and emotional toll on patients that undergo therapeutic plasma exchange (TPE) treatments. Previous literature has shown that these patients may feel a greater sense of self-burden. Motivational Interviewing (MI) is a technique used in vario...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21645
更新日期:2018-10-01 00:00:00
abstract::Acute thrombotic thrombocytopenic purpura (TTP) occurred in three patients following abdominal surgeries. One patient underwent extensive lysis for intestinal adhesions with bowel resection, another cholecystectomy for acute cholecystitis, and the third right colectomy and partial intestinal resection for colon cancer...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/1098-1101(2000)15:3<176::aid-jca4>3.0.co;2
更新日期:2000-01-01 00:00:00
abstract::Peripheral blood stem cells (PBSC) reinfusion appears to hasten hematologic reconstitution following myeloablative therapy. While procurement of PBSC adds apheresis procedures, rapid engraftment could decrease the demand for platelet transfusions. To determine the impact of PBSC collection on workload in our apheresis...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920070408
更新日期:1992-01-01 00:00:00
abstract::Current management of heparin-induced thrombocytopenia (HIT) involves prompt discontinuation of all heparin products and concomitant initiation of a direct thrombin or anti-Xa inhibitor for anticoagulation. In the setting of HIT complicated by an urgent need for cardiopulmonary bypass (CPB), the safety and the efficac...
journal_title:Journal of clinical apheresis
pub_type:
doi:10.1002/jca.21671
更新日期:2019-02-01 00:00:00
abstract::Treatment by low density lipoprotein (LDL) apheresis using dextran sulfate columns (DSC) leads to hemostasis alterations with prolonged activated partial thromboplastin time (APTT) of more than 120 seconds. In order to explain this hypocoagulability, we studied hemostasis parameters both in patients and in the extraco...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920080302
更新日期:1993-01-01 00:00:00
abstract::Many apheresis units lack the resources to acquire customized computer software for record keeping. We have adapted a commercially available "spreadsheet" program (Lotus 1-2-3) to aid in quality control activities for plateletpheresis. Data are entered in a grid pattern wherein each donation occupies one row and succe...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920050407
更新日期:1990-01-01 00:00:00
abstract::We describe the case of a 24 year old male with severe fistulating Crohn's disease who failed mutliple modalities of medical and surgical therapy. We present objective and subjective evidence of disease remission after induction and maintenance treatment with leukocyte apheresis. This is the first described case of su...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21308
更新日期:2014-06-01 00:00:00
abstract::The blood flow property is one of the factors determining blood perfusion and oxygen supply. The viscosity of the blood is primarily related to the hematocrit, but also to the amount of fibrinogen and other macromolecules present in the blood. Patients with ischemic heart disease have shown a rapid and safe improvemen...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/(sici)1098-1101(1997)12:4<183::aid-jca5>3.
更新日期:1997-01-01 00:00:00
abstract:INTRODUCTION:Nanoscale particle-based drug delivery systems like long circulating liposomal doxorubicin show unique pharmacokinetic properties and improved toxicity profiles. Liposomal doxorubicin accumulates in tumor tissue due to the enhanced permeation and retention effect, but only a small fraction of a total dose ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20229
更新日期:2010-01-01 00:00:00
abstract::Heparin-induced thrombocytopenia (HIT) can occur following exposure to heparin and is characterized by thrombocytopenia with increased risk for thrombosis. This condition is mediated by formation of immunoglobulin G antibodies against platelet factor 4/heparin complexes that can subsequently lead to platelet activatio...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21757
更新日期:2020-01-01 00:00:00