Initial experience with high-volume plasma exchange in patients with acute liver failure.


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.


J Clin Apher


Kim JE,Chun S,Sinn DH,Kim NJ,Kim S,Kang W,Kim JM,Choi GS,Joh JW,Cho D




Has Abstract


2021-01-05 00:00:00






  • Acute hemolytic transfusion reaction in a pediatric patient following transfusion of apheresis platelets.

    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


    authors: Sapatnekar S,Sharma G,Downes KA,Wiersma S,McGrath C,Yomtovían R

    更新日期:2005-12-01 00:00:00

  • Convalescent plasma therapy in patients with COVID-19.

    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


    authors: Yiğenoğlu TN,Hacıbekiroğlu T,Berber İ,Dal MS,Baştürk A,Namdaroğlu S,Korkmaz S,Ulas T,Dal T,Erkurt MA,Turgut B,Altuntaş F

    更新日期:2020-08-01 00:00:00

  • Folinic acid does not mobilize hemopoietic progenitors following repeated consolidation chemotherapy for acute leukemia.

    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


    authors: Teshima T,Harada M,Takamatsu Y,Inaba S,Kondo S,Akashi K,Okamura T,Niho Y

    更新日期:1992-01-01 00:00:00

  • Successful management of a Jehovah's Witness with thrombotic thrombocytopenic purpura unwilling to be treated with therapeutic plasma exchange.

    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


    authors: Dabak V,Kuriakose P,Raman S

    更新日期:2007-01-01 00:00:00

  • Modification of the leukapheresis procedure for use in rhesus monkeys (Macaca mulata).

    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


    authors: Ageyama N,Kimikawa M,Eguchi K,Ono F,Shibata H,Yoshikawa Y,Terao K

    更新日期:2003-01-01 00:00:00

  • Hematopoietic stem cell processing and cryopreservation.

    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


    authors: Rowley SD

    更新日期:1992-01-01 00:00:00

  • Randomized controlled trials in therapeutic apheresis.

    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


    authors: Winters JL

    更新日期:2013-02-01 00:00:00

  • Efficacy of plasmapheresis and semi-selective immunoadsorption for removal of anti-HLA antibodies.

    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


    authors: Jambon F,Merville P,Guidicelli G,Taton B,De Précigout V,Couzi L,Moreau K,Visentin J

    更新日期:2020-11-30 00:00:00

  • Prediction of immunoglobulin M reduction via therapeutic dose of simple plasma exchange and double filtration plasmapheresis using membrane separation in patients with hyperviscosity syndrome caused by Waldenstrom macroglobulinemia.

    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

    pub_type: 杂志文章


    authors: Miyamoto Y,Hamasaki Y,Matsumoto A,Doi K,Noiri E,Nangaku M

    更新日期:2018-10-01 00:00:00

  • Differentiating thrombotic microangiopathies induced by severe hypertension from anemia and thrombocytopenia seen in thrombotic thrombocytopenia purpura.

    abstract::Thrombotic microangiopathy (TMA) is a recognized complication of malignant hypertension (HTN). Such patients have blood pressures > or = 200/140 mmHg but the condition is defined by the presence of papilledema and is frequently complicated by acute renal failure. Here we report two patients with severe HTN (systolic >...

    journal_title:Journal of clinical apheresis

    pub_type: 杂志文章


    authors: Egan JA,Bandarenko N,Hay SN,Paradowski L,Goldberg R,Nickeleit V,Brecher ME

    更新日期:2004-01-01 00:00:00

  • Extracorporeal photopheresis reduces the number of mononuclear cells that produce pro-inflammatory cytokines, when tested ex-vivo.

    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


    authors: Bladon J,Taylor P

    更新日期:2002-01-01 00:00:00

  • Physiological measurements corroborate symptomatic improvement after therapeutic leukapheresis in a pregnant woman with chronic myelogenous leukemia.

    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



    authors: Galera P,Haynes S,Sulmasy P,Bailey JA,Greene M,Vauthrin M,Brettler D,Liebmann J,Mark Madison J,Weinstein R

    更新日期:2016-08-01 00:00:00

  • ABO-incompatible living donor kidney transplantation without post-transplant therapeutic plasma exchange.

    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


    authors: Yabu JM,Fontaine MJ

    更新日期:2015-12-01 00:00:00

  • Effects of extracorporeal hemapheresis therapy on blood rheology.

    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


    authors: Fadul JE,Linde T,Sandhagen B,Wikström B,Danielson BG

    更新日期:1997-01-01 00:00:00

  • Sequential transplants using mobilized peripheral blood progenitor cells.

    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


    authors: Ghalie R,Richman CM,Bender JG,McLeod BC,Lee W,Czyzewski A,Manson S,Cobleigh MA,Reed S,Pierre R

    更新日期:1994-01-01 00:00:00

  • Physician coverage of therapeutic apheresis.

    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


    authors: Woll JE

    更新日期:1995-01-01 00:00:00

  • Red cell exchange to mitigate a delayed hemolytic transfusion reaction in a patient transfused with incompatible red blood cells.

    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


    authors: Irani MS,Karafin MS,Ernster L

    更新日期:2017-02-01 00:00:00

  • Surviving peer review.

    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


    authors: Weinstein R

    更新日期:2020-08-07 00:00:00

  • Effect of blood group on idiopathic thrombotic thrombocytopenic purpura.

    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


    authors: Zuberi L,Yerasuri D,Kuriakose P

    更新日期:2009-01-01 00:00:00

  • Early response to caplacizumab and rituximab after anaphylaxis to Octaplas plasma in a patient with thrombotic thrombocytopenic purpura.

    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



    authors: Perrone S,Passucci M,Ortu La Barbera E,Capriata M,Ferretti A,Mecozzi A,Giovangrossi P,Equitani F,Cimino G

    更新日期:2021-01-18 00:00:00

  • Factors affecting platelet yield and their impact on the platelet increment of patients receiving single donor PLT transfusion.

    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


    authors: Enein AA,Hussein EA,El Shafie S,Hallouda M

    更新日期:2007-02-01 00:00:00

  • Transfusion-related acute lung injury: a thrombotic thrombocytopenic purpura treatment-associated case report and concise review.

    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


    authors: Cruz J,Skipworth E,Blue D,Waxman D,McCarthy L,Smith D

    更新日期:2008-01-01 00:00:00

  • Prevention of Rh sensitization in the context of trauma: two case reports.

    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


    authors: Werch JB

    更新日期:2010-01-01 00:00:00

  • Preparation and storage of "leukocyte-depleted single donor" platelet concentrate: a step forward in effective haemotherapy.

    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


    authors: Elias MK,de Wolf JT,Blom N,Rijskamp L,Halie RM,Smit Sibinga CT

    更新日期:1991-01-01 00:00:00

  • Plerixafor as preemptive strategy results in high success rates in autologous stem cell mobilization failure.

    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


    authors: Worel N,Fritsch G,Agis H,Böhm A,Engelich G,Leitner GC,Geissler K,Gleixner K,Kalhs P,Buxhofer-Ausch V,Keil F,Kopetzky G,Mayr V,Rabitsch W,Reisner R,Rosskopf K,Ruckser R,Zoghlami C,Zojer N,Greinix HT

    更新日期:2017-08-01 00:00:00

  • Research and development in the blood bank: efforts of a hospital donor center to improve efficiency of in-line leukocyte reduction filters for automated plateletpheresis.

    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


    authors: Drew MJ,Hodges J

    更新日期:1995-01-01 00:00:00

  • Aluminium loading during therapeutic plasma exchange.

    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


    authors: Monteagudo F,Wood L,Jacobs P,Folb P,Cassidy M

    更新日期:1987-01-01 00:00:00

  • Therapeutic plasma exchange in recurrent focal segmental glomerulosclerosis following transplantation.

    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


    authors: Shariatmadar S,Noto TA

    更新日期:2002-01-01 00:00:00

  • Effect of heparin-induced extracorporeal lipoprotein apheresis on renal function.

    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


    authors: Chandran PK

    更新日期:2011-01-01 00:00:00

  • Lipid-apheresis improves microcirculation of the upper limbs.

    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


    authors: Rossenbach J,Mueller GA,Lange K,Armstrong VW,Schmitto JD,Hintze E,Helfmann J,Konstantinides S,Koziolek MJ

    更新日期:2011-01-01 00:00:00