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::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::Complement-derived anaphylatoxin may be one of the causes of vascular injury and an indicator of activity in systemic lupus erythematosus (SLE). The present study examines the effectiveness of dextran sulfate (DS) column immunoadsorption treatment to remove anaphylatoxins (C3a, C4a, and C5a) from the blood of patients...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/(sici)1098-1101(1998)13:3<108::aid-jca3>3.
更新日期:1998-01-01 00:00:00
abstract:PURPOSE:A red cell exchange was performed to prevent a potentially fatal hemolytic transfusion reaction in a patient with anti-e who was transfused with e-antigen unscreened red blood cells during liver transplant surgery. CASE REPORT:A 64-year-old woman with cirrhosis due to hepatitis C was scheduled to receive a liv...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21461
更新日期:2017-02-01 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::This study was undertaken to evaluate the relationship between the time to recovery of peripheral blood counts and CD34+ cells in the peripheral blood (PB) and apheresis collections of patients undergoing intensive chemotherapy followed by rhG-CSF. Twenty-three patients with a median age of 42 years (range 17-64) with...
journal_title:Journal of clinical apheresis
pub_type: 临床试验,杂志文章
doi:10.1002/(sici)1098-1101(1998)13:1<1::aid-jca1>3.0.
更新日期:1998-01-01 00:00:00
abstract::Extracorporeal photopheresis (ECP) has been shown to be clinically effective in the treatment of many T cell-mediated conditions. ECP's mechanism of action includes the induction of apoptosis and the release of pro-inflammatory cytokines. Recently, we have observed early lymphoid apoptosis, detectable immediately post...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.10039
更新日期:2002-01-01 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 literature on the use of therapeutic apheresis is often criticized for the preponderance of low to very low quality evidence. Shehata et al. examined the apheresis literature published between 1976 and 1999 and found a lack of randomized controlled trials with those identified demonstrating significant limitations...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,评审
doi:10.1002/jca.21263
更新日期:2013-02-01 00:00:00
abstract::Apheresis procedures in small children are technically challenging and require special planning with attention to extracorporeal volume. Discontinuous procedures such as extracorporeal photopheresis (ECP) require additional consideration. Alternative methods to perform ECP have been utilized in small children that req...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20231
更新日期:2010-01-01 00:00:00
abstract::Recently very potent extracorporeal cholesterol-lowering treatment options have become available for patients with hypercholesterolemia. LDL immunoapheresis treatment selectively removes LDL and lipoprotein(a) from the circulation. Since LDL is the major carrier of lipophilic antioxidants in plasma, the purpose of the...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20026
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Myeloid-derived leucocytes, a major source of inflammatory cytokines, play an important role in the exacerbation of ulcerative colitis (UC). Selective depletion of myeloid leucocytes by adsorptive granulomonocytapheresis (GMA) with an Adacolumn should alleviate inflammation and promote remission. However, th...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21787
更新日期:2020-08-01 00:00:00
abstract::Modern techniques of mechanical hemapheresis have made it possible to selectively remove vast quantities of lymphocytes and plasma immunoglobulins, and the concentration of these substances in donor blood can fall below the normal range. It is feared that this may lead to immunosuppression; a condition associated in s...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920020112
更新日期:1984-01-01 00:00:00
abstract::Targeted extracorporeal granulocyte and monocyte apheresis (GMA) has produced clinical efficacy together with down modulation of specific inflammatory cytokines in patients with ulcerative colitis (UC). This study was to investigate if preoperative GMA produces immunological effect on dysregulated immune activity afte...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,随机对照试验
doi:10.1002/jca.21299
更新日期:2014-04-01 00:00:00
abstract::Either bone marrow or peripheral blood may be harvested to provide hematopoietic stem cells (HSC) for autologous transplantation. Both, however, comprise heterogeneous cell populations. The HSC necessary for successful engraftment constitute a very small fraction of the cells harvested. After collection, the harvested...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,评审
doi:10.1002/jca.2920070307
更新日期:1992-01-01 00:00:00
abstract::Leukemic-dendritic cells (leukemic-DCs) have certain limitations, which include difficult generation in 30-40% of patients, and low levels of expression of several key molecules. Therefore, an alternative approach using monocyte-derived DCs pulsed with tumor antigens is required. We investigated the possibility of imm...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20085
更新日期:2006-10-01 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::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::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::Until recently, the collection of peripheral blood progenitor cells (PBPC) has been semi-automated by using the COBE Spectra, with the operator manually maintaining the position of the white cells being collected. The COBE Spectra Version 6.0 apheresis device offers the user an automated program for the collection of ...
journal_title:Journal of clinical apheresis
pub_type: 临床试验,杂志文章
doi:10.1002/(sici)1098-1101(1999)14:1<26::aid-jca5>3.0
更新日期:1999-01-01 00:00:00
abstract::In-line leukocyte reduction filters (LRF) are available for use with an automated plateletpheresis (PPH) system. Initially, 62% of PPH units produced with such a filter (LRF6, N = 29) had postfiltration (POF) white blood cell (WBC) counts < 5 x 10(6), with a mean POF WBC of 42 x 10(6). In an attempt to decrease POF WB...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920100204
更新日期:1995-01-01 00:00:00
abstract::Dysmetabolic iron overload syndrome is a rare event causing hepatic impairment with serious long-term side effects. Here, we describe a case of metabolic syndrome-related hepatic iron overload that showed a rapid, effective, and safe response to erythrocytapheresis. J. Clin. Apheresis 31:443-447, 2016. © 2015 Wiley Pe...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21434
更新日期:2016-10-01 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::Staphylococcal protein A efficiently binds immunoglobulins and circulating immune complexes (CIC) and provides an effective medium to remove immunoglobulins and CICs from plasma while sparing albumin and most coagulation proteins. Although it activates the complement system its clinical use abrogates the need for plas...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,评审
doi:10.1002/jca.2920090109
更新日期:1994-01-01 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::The removal of specific antibody in experimental animals has been reported to result in a subsequent increase in antibody to levels equal to (rebound) or exceeding those existing prior to removal (overshoot). Anecdotal reports suggest that rebound antibody synthesis after plasmapheresis may occur in humans with autoim...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920050304
更新日期:1990-01-01 00:00:00
abstract::Inadvertent hypothermia due to massive infusion of stored blood can be prevented by pretransfusion warming. One approach is the heating of individual packs by means of electromagnetic conduction, which is a method safely used over the last 25 years. The prototype instrument, which has now been re-engineered, can effec...
journal_title:Journal of clinical apheresis
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/jca.2920070105
更新日期:1992-01-01 00:00:00
abstract::Graphite furnace atomic absorption spectroscopy was used to demonstrate a fivefold increase in the median plasma aluminium levels of four patients undergoing therapeutic plasmapheresis. This plasma aluminium loading resulted from contamination of albumin incorporated in the replacement fluids and took place during its...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920030306
更新日期:1987-01-01 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::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::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