Double Filtration Plasmapheresis In Patients Research Articles

Influence of patient factors on target plasma volume treated attainment rate during double filtration plasmapheresis in patients with hypertriglyceridemic acute pancreatitis.

This study aims to investigate patient factors affecting the rate of plasma volume target attained in hypertriglyceridemic pancreatitis (HTG-AP) patients undergoing double filtration plasmapheresis (DFPP). A retrospective analysis of 82 HTG-AP-interpreted patients from January 2019 to April 2024 compared target plasma volume treated between up-to-scratch and non-scratch groups. The group comparison used independent samples t-test, Mann-Whitney U-test, and chi-square test. Binary logistic regression was used to identify independent risk factors for patients' plasma volume target failure. The ROC curve assessed these risk factors' diagnostic efficacy. Of 82 patients, 52 were classified as belonging to the up-to-scratch group, while the remaining 30 were classified as belonging to the non-to-scratch group. Statistically significant differences were seen between the groups regarding admission heart rate, triglyceride, calcitonin gene, C-reactive protein, D-dimer, and fibrinogen (FIB) levels (p <0.05). The binary logistic regression analysis showed that for every 1 mmol/L increase in triglycerides (TG), the probability of experiencing substandard target plasma handling increased by 5.0% (OR = 1.05, 95%CI 1.01-1.08, p = 0.009). Furthermore, for each g/L rise in FIB, there was a 74% increase in the likelihood of encountering suboptimal target plasma handling (OR = 1.74, 95%CI 1.18-2.56, p = 0.005). The ROC curve study revealed that the AUC for TG was 0.67, for FIB was 0.77, and for the combination of both markers was 0.80; all the p values were below 0.05. The increased levels of TG and FIB are independent risk factors affecting the target plasma handling achievement rate in HTG-AP patients undergoing DFPP.

Dynamics of Structural and Functional Changes of Patients with Dry Form Age-related Macular Degeneration after Double Filtration Plasmapheresis

Actuality. One of the significant ophthalmic diseases is a dry form age-related macular degeneration (dAMD). The issues of etiology and pathogenesis are not completely cleared nowadays and they signify the subject of discussion. There are risk factors of dAMD (age, heredity, lifestyle etc.) which can cause metabolic disorders, changes hemorheological parameters which promote activation of druseogenesis and as a result an angiogenesis. Mostly an outcome of dAMD is geographical atrophy and decrease of central visual acuity. At the same time, it is known that similar metabolic and rheological disorders detected in other diseases are effectively corrected by extracorporeal rheoaferesis, in particular, using double filtration plasmapheresis. Thus, using of extracorporeal rheoaferesis with dAMD patients is pathogenetically well-reasoned, but in the available literature, a correct analysis of the effectiveness and safety of double filtration plasmapheresis in patients with intermediate stage of dAMD is presented poorly.Objective. To study along with data of OCT, OCT angiography, visometry, microperimetry and electroretinography structural and functional changes in the macular zone in patients with a dry form of age-related macular degeneration after the using of double filtration plasmapheresis.Patients and methods. The study included 63 patients (94 eyes) with an intermediate stage of dAMD. The patients were separated into two groups randomly. The first (main) group included 34 patients (52 eyes) who were performed double filtration plasmapheresis (DFPP) on an OctoNova device using a Plasmaflo plasma filter and a Cascadeflo EC40 fractionator in the amount of 4 procedures with a frequency of 1 time per week for 1 month. The second group (control) included 29 patients (42 eyes) who did not receive any specific treatment. In the main group of patients, OCT, OCT angiography, microperimetry and electroretinography were additionally performed in addition to standard ophthalmological examination before the DFPP course, after the DFPP course (1 month after the start of follow-up), 6 and 12 months later. Patients in the control group also underwent a similar examination at the specified time — 1, 6, 12 months after the start of follow-up.Results. In this study we found according to optical coherence tomography, optical coherence tomography-angiography, visometry, microperimetry and electroretinography, positive dynamics of structural and functional parameters of the macular retina is observed in patients with a dry form of age-related macular degeneration with using double filtration plasmapheresis. At the same time, a statistically significant difference between the two groups begins at 1 month and persists for 12 months of follow-up, which points to stabilization of the pathological process during the specified period.Conclusions. This study showed that after applying the double filtration plasmapheresis in patients with dry form of age-related macular degeneration, there is an improvement in structural and functional parameters of the macular zone, consisting in a decrease volume DOPES and stabilization of retinal light sensitivity.

Efficacy of double filtration plasmapheresis combined with immunosuppressive agents in the treatment of severe lupus nephritis.

To evaluate the efficacy of double filtration plasmapheresis combined with immunosuppressive agents in the treatment of severe lupus nephritis. A retrospective analysis was conducted on the medical records of 102 cases of severe lupus nephritis treated between January 2021 and December 2022 in the General Practice Department at the Affiliated Hospital of North Sichuan Medical College. Patients who received immunosuppressive agents were included in the control group and those who received additional double filtration plasmapheresis were included in the observation group. Changes in liver and kidney function indicators, immune function indicators, disease activity, peripheral blood immunoglobulins, total albumin levels, gamma globulin levels, erythrocyte sedimentation rates (ESR), and inflammatory marker levels, and overall clinical efficacy were compared between the two groups. After therapy, kidney function indicators in the observation group were lower than in the control group, while serum albumin (Alb), total albumin level, complement component 3 (C3) and C4 levels were higher (all P<0.05). Anti-double-stranded DNA antibody (ds-DNA) and white blood cell (WBC) counts in the observation group were also lower than those in the control group. Additionally, the systemic lupus erythematosus disease activity index (SLEDAI) scores, the levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), and ESR were lower in the observation group than those in the control group (all P<0.05). The total clinical effective rate was higher in the observation group than in the control group (P<0.05). The combination of immunosuppressive agents with double filtration plasmapheresis in patients with severe lupus nephritis can significantly improve liver and kidney function, enhance immune function, and reduce inflammation, demonstrating good therapeutic effects and safety.

Prognostic factors and complication rates for double-filtration plasmapheresis in patients with Guillain–Barré syndrome

Guillain–Barré syndrome (GBS) is an acute immune-mediated demyelinating polyradiculoneuropathy that could lead to disabilities if not properly treated. There are only limited data on the prognostic factors and complications when using double-filtration plasmapheresis in these patients. We reviewed the medical records of 60 GBS patients who underwent double-filtration plasmapheresis as the first-line therapy at a tertiary care teaching hospital. The severity of disease was evaluated at different time points using disability scores. Functional outcome was defined as good (GBS disability score 0 to 2) or poor (GBS disability score 3 to 6) at 28 days after admission. The cohort included 22 women and 38 men with a mean age of 50 ± 18 years. In univariate logistic regression analysis, potential factors associated with poor outcome include an older age (P = 0.101), the absence of preceding respiratory tract infection (P = 0.043), mechanical ventilation (P = 0.016), a lower hematocrit (p = 0.072), a lower serum sodium level (P = 0.153) and a higher disability score on admission (P < 0.001). In multivariate analysis, a higher disability score on admission was associated with a poorer outcome (OR, 5.61; 95% CI, 2.34 to 13.43; P < 0.001), whereas the presence of prodromal upper respiratory tract infection correlated with a better outcome (OR, 0.13; 95% CI, 0.03–0.59; P = 0.009). Among 60 patients, eleven (18.3%) have various complications attributed to plasmapheresis treatment. Six patients (10.0%) developed deep vein thrombosis and two experienced catheter-related infection (3.3%). Hypotension, allergy and hemolysis occurred in one patient each (1.7%). In conclusion, we describe our experiences of using DFPP in the treatment of GBS. The pretreatment severity score was the most significant predictor of treatment outcome, suggesting that early referral and timely treatment are important. Potential complications such as catheter-related infection and deep vein thrombosis should be monitored carefully.

Utility of Double Filtration Plasmapheresis in Acute Antibody Mediated Renal Allograft Rejection: Report of Three Cases

Plasmapheresis is an extracorporeal procedure, which is often employed to rapidly lower circulating titers of autoantibodies, immune complexes or toxins. There are two types of plasmapheresis namely, regular plasmapheresis (RPP) by centrifugation and membrane fi ltration, and double fi ltration plasmapheresis (DFPP) which is a special form of membrane fi ltration in which two membranes called as plasma separator and plasma fractionator are employed to fi lter macromolecules more selectively. DFPP have several advantages over RP. Despite widespread utilization of DFPP in the setting of ABO blood group incompatible kidney transplantation, there is no report regarding DFPP in patients with antibody mediated acute renal allograft rejection who are good candidates for benefi cial effects of DFPP. Here we report three renal transplant recipients in whom DFPP was applied as a component of anti-rejection treatment regimen.

Therapeutic efficacy of double filtration plasmapheresis in patients with anti-aquaporin-4 antibody-positive multiple sclerosis

Multiple sclerosis (MS) in Asian countries, including Japan, is classified into two types: conventional MS (C–MS), characterized mainly by cerebral lesions, and opticospinal MS (OS–MS) or neuromyelitis optica (NMO), characterized by selective involvement of the optic nerve and spinal cord. Recently, a serum immunoglobulin-G-antibody was discovered in patients with NMO that targets aquaporin-4 (AQP4). The existence of the anti-AQP4 antibody shows the pathogenetic role of humoral immune factors in OS–MS/NMO. We treated eight patients with anti-AQP4 antibody-positive MS with double filtration plasmapheresis (DFPP) to remove the antibody. Improvement of vision was observed in two patients. Motion improvement was seen in seven patients. Sensory improvement was observed in four patients. In total, six out of eight patients (75%) showed therapeutic improvement after DFPP treatment. We propose that DFPP might be an effective therapeutic option for patients with anti-AQP4 antibody-positive MS.