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 efficacy of short-term heparin-based anticoagulation after therapeutic plasma exchange (TPE) have been previously demonstrated. Patients with HIT requiring TPE are frequently on extracorporeal circuits (either CPB, extracorporeal membrane oxygenation [ECMO] or external ventricular assist devices [VADs]). Performing TPE in parallel with these circuits involves additional consideration for circuit size, anticoagulant/citrate management, as well as flow rates, and risk of air embolus. We report a case of a patient with HIT on external biventricular assist device (BiVAD) requiring urgent CPB who experienced thrombotic and hemolytic complications related to anticoagulation management around apheresis line placement for TPE. We also present results from a national survey of academic apheresis services regarding specific practices in managing patients with HIT on extracorporeal circuits who require TPE. In addition, we demonstrate the utility of TPE in patients with HIT on extracorporeal circuits and the risks of this procedure and the need to develop practice guidelines.
journal_name
J Clin Apherjournal_title
Journal of clinical apheresisauthors
Cho JH,Parilla M,Treml A,Wool GDdoi
10.1002/jca.21671subject
Has Abstractpub_date
2019-02-01 00:00:00pages
64-72issue
1eissn
0733-2459issn
1098-1101journal_volume
34pub_type
abstract：OBJECTIVE:Effects of therapeutic plasma exchange (TPE) on immune cells and their cytokine production in MS, are unknown. Since interleukine-6 and tumor growth factor-β have critical roles in MS immunopathogenesis, the impacts of TPE on the expression of these cytokines and their receptors on the surface of CD4+ T lymph...
journal_title：Journal of clinical apheresis
pub_type： 杂志文章
doi：10.1002/jca.21755
更新日期：2020-04-01 00:00:00
abstract：:Therapeutic plasma exchange (TPE) is an increasingly utilized immunosuppressive adjunct for treatment of antibody-mediated rejection (AMR) following organ transplantation. TPE works through removal of donor-specific HLA antibodies (DSAs) in the recipient's plasma. However, there is no clear laboratory measure evaluati...
journal_title：Journal of clinical apheresis
pub_type： 杂志文章
doi：10.1002/jca.21270
更新日期：2013-08-01 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
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：: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
doi：10.1002/jca.20016
更新日期：2004-01-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:Specialized centers claim a need for blood component production independent from the general blood transfusion services. We performed a prospective change control analysis of the transfer of platelet (PLT) production for hematological patients at the University Hospital Basel from the Departme...
journal_title：Journal of clinical apheresis
pub_type： 杂志文章
doi：10.1002/jca.21214
更新日期：2012-01-01 00:00:00
abstract：:When harvesting peripheral progenitor cells (PPC) in children, the special situation of their circulatory system has to be taken into account. Therefore, extracorporeal blood volume and product volume should be small to avoid side effects. Nine children (age 2-14 years, weight 12.8-58.5 kg) with malignancies underwent...
journal_title：Journal of clinical apheresis
pub_type： 杂志文章
doi：10.1002/jca.10050
更新日期：2003-01-01 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：:The issues of providing quality blood products and maintaining donor safety are primary aims of blood transfusion services. A comprehensive quality system should be in place to fulfill these aims, which can be attained through strict adherence to the established standard operating procedures (SOPs). The Drugs and Cosm...
journal_title：Journal of clinical apheresis
pub_type： 杂志文章
doi：10.1002/jca.20056
更新日期：2005-07-01 00:00:00
abstract：:Granulocyte-colony stimulating factor (G-CSF) mobilizes and increases the amount of hematopoietic stem cells in peripheral blood, enabling its harvest by few apheresis procedures. The pegylated G-CSF has longer half-life and is given once only, which is more comfortable for patients, whereas the non-pegylated requires...
journal_title：Journal of clinical apheresis
pub_type： 杂志文章,meta分析,评审
doi：10.1002/jca.21550
更新日期：2017-12-01 00:00:00
abstract：:Mobilized PBSC are the main source for allogeneic HSCT. We aimed to evaluate factors that affect CD34+ cell yield including the donor's age, gender, BSA, processed blood volume and the method of G-CSF dose calculation. Data from 170 healthy donors were analyzed. The concentration of CD34+ cells in the peripheral blood...
journal_title：Journal of clinical apheresis
pub_type： 杂志文章
doi：10.1002/jca.21524
更新日期：2017-12-01 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：BACKGROUND:Dysphagia screening is oftentimes a focus of hospitalized patients, but dysphagia can also occur in outpatient settings. Dysphagia can be overlooked by nurses and clinicians, and it is therefore important to educate nurses on the importance of dysphagia screenings. METHODS:This was a randomized prospective ...
journal_title：Journal of clinical apheresis
pub_type： 杂志文章,随机对照试验
doi：10.1002/jca.21572
更新日期：2018-02-01 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：: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：: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：:An improved method for intermittent-flow erythrocytapheresis in patients with sickle cell disease is reported. The method, a modification of the standard red cell exchange procedure for the Haemonetics 30S unit, dilutes with physiologic saline the patient's blood as it flows from the draw line and before it reaches th...
journal_title：Journal of clinical apheresis
pub_type： 杂志文章
doi：10.1002/jca.2920030203
更新日期：1986-01-01 00:00:00
abstract：BACKGROUND:Perioperative therapeutic plasma exchange in patients with cardiovascular diseases poses several challenges, including alterations in intravascular volume, serum electrolytes, the coagulation cascade, and drug pharmacokinetics. METHODS:This review article summarizes different indications of plasma exchange ...
journal_title：Journal of clinical apheresis
pub_type： 杂志文章,评审
doi：10.1002/jca.21676
更新日期：2019-08-01 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：: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：: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：: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：: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：:Prestorage leukocyte reduction of platelet concentrates may reduce adverse effects of transfusion while affording better quality control. Platelets and leukocytes may undergo activation during storage, which could affect the performance of leukocyte reduction filters. The purpose of this study was to evaluate the effi...
journal_title：Journal of clinical apheresis
pub_type： 杂志文章
doi：10.1002/(sici)1098-1101(1997)12:1<14::aid-jca4>3.0
更新日期：1997-01-01 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：:The Oklahoma TTP-HUS Registry provides a complete community perspective of thrombotic thrombocytopenic purpura (TTP). This is possible because plasma exchange is the essential treatment for TTP and the Oklahoma Blood Institute provides all plasma exchange procedures for a region encompassing most of the State, includi...
journal_title：Journal of clinical apheresis
pub_type： 杂志文章
doi：10.1002/jca.20169
更新日期：2008-01-01 00:00:00
abstract：:Lipoprotein apheresis is applied to deplete low density lipoprotein and other apolipoprotein B containing lipoproteins in patients with severe familial hypercholesterolemia, hypertriglyceridemia associated pancreatitis, or lipoprotein (a)-hyperlipoproteinemia. Anticoagulation of the extracorporeal circuit may influenc...
journal_title：Journal of clinical apheresis
pub_type： 杂志文章
doi：10.1002/jca.21519
更新日期：2017-12-01 00:00:00
abstract：:The combined use of immunoadsorption (IA) and membrane filtration (MF) may markedly enhance removal of IgM and complement component C1q, supporting its use as an element of recipient desensitization in antibody-incompatible transplantation. However, coagulation factor removal may contribute to altered hemostasis, posi...
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.21399
更新日期：2016-02-01 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：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
