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, posing a risk of bleeding in the perioperative setting. This secondary endpoint analysis of standard coagulation assays and rotational thromboelastometry (ROTEM®) was performed in the context of a randomized controlled crossover study designed to assess the effect of combined IA (GAM-146-peptide) and MF on levels of ABO antigen-specific IgM. Fourteen patients with autoimmune disorders were randomized to a single treatment with IA+MF followed by IA alone, or vice versa. MF was found to markedly enhance fibrinogen depletion (57% vs. 28% median decrease after IA alone, P < 0.001), whereby four patients showed post-treatment fibrinogen concentrations below 100 mg dL(-1). In support of a critical contribution of fibrinogen depletion to impaired coagulation, extrinsically activated ROTEM(®) analysis revealed a marked reduction in fibrinogen-dependent clot formation upon IA+MF (59% median decrease in FIBTEM mean clot firmness (MCF) as compared to 24% after IA alone, P < 0.001). Moreover, the addition of MF led to a substantial prolongation of activated partial thromboplastin time, possibly due to depletion of macromolecular coagulation factors contributing to intrinsically activated coagulation. Our study demonstrates substantial effects of combined IA+MF on clot formation, which may be mainly attributable to fibrinogen depletion. We suggest that the use of combined apheresis in the setting of transplant surgery may necessitate a careful monitoring of coagulation.
journal_name
J Clin Apherjournal_title
Journal of clinical apheresisauthors
Biesenbach P,Eskandary F,Ay C,Wiegele M,Derfler K,Schaden E,Haslacher H,Oberbauer R,Böhmig GAdoi
10.1002/jca.21399subject
Has Abstractpub_date
2016-02-01 00:00:00pages
29-37issue
1eissn
0733-2459issn
1098-1101journal_volume
31pub_type
临床试验,杂志文章,随机对照试验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::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::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::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::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::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::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::Since the introduction of hematopoietic growth factors, the collection of mobilized stem cells via leukapheresis has widely replaced the harvest of bone marrow in both autologous and allogeneic transplantation settings. We investigated the frequency and the extent of anticoagulant-induced electrolyte changes and the c...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/1098-1101(2000)15:4<230::aid-jca3>3.0.co;2
更新日期:2000-01-01 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:INTRODUCTION:Algorithms have been developed to predict the platelet yield after apheresis from the donor's data, as well as the effect on the blood cell count, to extract an acceptable platelet number without affecting the donor. However, the evaluation of these algorithms has not been widely reported. This study aimed...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21846
更新日期:2020-10-05 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::This study chronicles leukocyte- and erythrocyte-depleted platelet concentrate collection by a dual stage channel in which three variables: 1) donor peripheral blood platelet concentration, 2) total blood processed, and 3) collection volume were statistically correlated with platelet yield as determined by a multiple ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920020304
更新日期:1985-01-01 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::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::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::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::Extra-corporeal photopheresis (ECP) is known as safe ultimate treatment option for chronic lung allograft dysfunction (CLAD). Here, we report the first case of ECP as "second-line" immunomodulatory therapy early post-transplant in an adult patient undergoing lung transplantation for severe chronic thromboembolic pulmo...
journal_title:Journal of clinical apheresis
pub_type:
doi:10.1002/jca.21831
更新日期:2020-08-24 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::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: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...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21873
更新日期:2021-01-05 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::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::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::Idiopathic inflammatory demyelinating diseases (IIDDs) of the central nervous system, of which multiple sclerosis is the prototype, represent a family of monophasic, recurrent or progressive diseases with overlapping clinical and pathological manifestations. While most patients recover spontaneously or following a bri...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,评审
doi:10.1002/(sici)1098-1101(1999)14:3<144::aid-jca7>3.
更新日期:1999-01-01 00:00:00
abstract::Transfusion-acquired babesiosis can be an asymptomatic or self-limited febrile hemolytic illness in a healthy host. A persistent, relapsing, and/or fulminant course with the development of life-threatening complications may be seen in immunocompromised or splenectomized patients. As in malaria, erythrocyte parasitemia...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20262
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Currently, low titer A plasma is used on a routine basis in bleeding trauma patients of unknown AB type. Three AB non-bleeding apheresis patients are presented here who safely received a combination of AB and low titer A plasma during therapeutic plasma exchange (TPE). One control AB patient received AB plas...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21656
更新日期:2019-02-01 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::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::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::Bone marrow (BM) damage after previous chemotherapy, such as that involving alkylating agents, and radiation therapy alone cannot explain poor hematopoietic progenitor cell mobilization. We examined the T lymphocytes of BM in 67 autologous peripheral blood stem cell transplant (auto-PBSCT) patients with non-Hodgkin ly...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21817
更新日期:2020-07-28 00:00:00