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 practice of transfusing ABO-incompatible platelets, driven primarily by concerns about inventory management, has been considered generally safe because the accompanying plasma is usually diluted in the recipient's total blood volume. However, if the platelet product contains a large volume of plasma or a high conc...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20072
更新日期:2005-12-01 00:00:00
abstract::There are currently no licensed vaccines or therapeutics for COVID-19. Anti-SARS CoV-2 antibody-containing plasmas, obtained from the recovered individuals who had confirmed COVID-19, have been started to be collected using apheresis devices and stored in blood banks in some countries in order to administer to the pat...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,评审
doi:10.1002/jca.21806
更新日期:2020-08-01 00:00:00
abstract::Folinic acid (FA) has been reported to expand the pool of peripheral blood stem cells (PBSC) after chemotherapy. We evaluated the efficacy of FA for harvesting PBSC following cytotoxic chemotherapy in 4 patients with acute leukemia. After achieving a complete remission (CR), 3 courses of chemotherapy for a consolidati...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920070410
更新日期:1992-01-01 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::One of the most serious problems in applying leukapheresis to human infants is the large extracorporeal blood volume (ECV), resulting in substantial loss of platelets and red blood cells (RBCs). In this study, we developed a safe and effective modified procedure to collect peripheral blood stem cells (PBSCs) from rhes...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.10043
更新日期:2003-01-01 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::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:BACKGROUND:In organ transplantation, apheresis is frequently used for removal of anti-HLA antibodies. However, it is unclear whether plasmapheresis (PP) or semi-selective immunoadsorption (IA) should be employed, and the optimal number of apheresis sessions required to reach post-treatment objectives is also unknown. ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21858
更新日期:2020-11-30 00:00:00
abstract:BACKGROUND:Plasma exchange (PE) and double filtration plasmapheresis (DFPP) are known as effective treatment options for hyperviscosity syndrome (HVS) caused by Waldenstrom macroglobulinemia. Nonetheless, few data are available for the relation between the prescribed dose of apheresis and the reduction rate of target m...
journal_title:Journal of clinical apheresis
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更新日期:2018-10-01 00:00:00
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journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20016
更新日期:2004-01-01 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::Therapeutic leukapheresis can control the white blood cell count (WBC) of pregnant women with chronic myelogenous leukemia (CML) who have hyperleukocytosis without leukostasis. The medical justification for this treatment has not been objectively documented. We report a 27-year-old woman, diagnosed with CML at 10-week...
journal_title:Journal of clinical apheresis
pub_type:
doi:10.1002/jca.21410
更新日期:2016-08-01 00:00:00
abstract::Blood group incompatibility remains a significant barrier to kidney transplantation. Approximately, one-third of donors are blood group incompatible with their intended recipient. Options for these donor-recipient pairs include blood group incompatible transplantation or kidney paired donation. However, the optimal pr...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21390
更新日期:2015-12-01 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::Modest success has been achieved with the use of high-dose cytotoxic therapy and bone marrow transplantation in solid tumors. Patient outcome can potentially be improved with further intensification of the therapy. The rapid hematologic recovery achieved with mobilized peripheral blood progenitor cells (PBPC) may redu...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920090307
更新日期:1994-01-01 00:00:00
abstract::A "snapshot" survey of physician coverage for evaluation and supervision of therapeutic apheresis procedures shows significant variation in current clinical practice between 39 blood center-and 41 non-blood center-based programs. Whereas 56% of blood center-based programs usually require physician's "in person" evalua...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920100405
更新日期:1995-01-01 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::The process of publishing original work in a peer review journal is not complete at the point where the manuscript is first submitted. The journal editors will submit the manuscript to peer review whereby outside experts are asked to vet the manuscript for scientific merit, originality and quality. Reviewers' comments...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,评审
doi:10.1002/jca.21822
更新日期:2020-08-07 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::Management of aTTP in patients who refuse or are intolerant to plasma remains challenging, but new drugs can be implemented with success. A 39-year-old woman presented to the Emergency department for bruises at the upper and lower limbs together with worsening anemia and thrombocytopenia; PLASMIC score was seven, indi...
journal_title:Journal of clinical apheresis
pub_type:
doi:10.1002/jca.21877
更新日期:2021-01-18 00:00:00
abstract::The aim of this study was to analyze the impact of various donor and machine parameters on PLT yield in 127 PLT apheresis procedures, to optimize PLT yield achieving clinical and economic advantages. One hundred and twenty-seven apheresis procedures were analyzed. Age, gender, volume processed, Hb, and PLT precounts w...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20116
更新日期:2007-02-01 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:BACKGROUND:Transfusion of D+ red blood cells (RBCs) to D- recipients can be accidental or necessary due to D- RBC shortage. Alloimmunization can complicate future transfusions; implications for women of childbearing age are compounded by possible hemolytic disease of the fetus and newborn. Rh immunoprophylaxis is effec...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20225
更新日期:2010-01-01 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::Plerixafor in combination with granulocyte-colony stimulating factor (G-CSF) is approved for autologous stem cell mobilization in poor mobilizing patients with multiple myeloma or malignant lymphoma. The purpose of this study was to evaluate efficacy and safety of plerixafor in an immediate rescue approach, administra...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21496
更新日期:2017-08-01 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::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::Focal segmental glomerulosclerosis (FSGS) recurs in 30% of renal allograft transplants with graft loss in half of the cases. A humoral factor may be implicated. We report on the use of therapeutic plasma exchange (TPE) in 11 patients with recurrent FSGS post transplantation. Medical records from 1989-2000 were reviewe...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.10025
更新日期:2002-01-01 00:00:00
abstract::During the course of heparin-induced extracorporeal lipoprotein apheresis, a patient with no prior known renal impairment or proteinuria demonstrated sustained improvement in estimated glomerular filtration rate, commensurate with reduction in serum lipids and creatine phosphokinase levels. Causes and implications of ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20272
更新日期:2011-01-01 00:00:00
abstract::Lipid-apheresis (LA) is thought to improve microcirculation. However, limited data are available on the effects on peripheral microcirculation. We investigated upper limb microcirculation of 22 patients undergoing regular LA on a weekly basis before and after LA. Using standardized semiquantitative scales, we analyzed...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20285
更新日期:2011-01-01 00:00:00