The developments in apheresis technologies and techniques and their clinical applications worldwide are technologically, sociologically, and economically motivated. As in the past apheresis surveys, the statistics have highlighted both the differences by geographic region in clinical practice and in the type of technologies utilized. While a national view of apheresis is very important, an international view may be more representative overall of this therapeutic modality than national results that are highly dependent on the local economics and the available technologies. These regional differences have provided a basis for scientific and clinical assessment of these apheresis technologies and their clinical outcomes, and have impacted the marketing and business developments of new technologies worldwide. The results of the International Apheresis Registry for 2007 report data from 20 centers on five continents. The survey collected data exclusively via a secure internet website on 1735 patients for a total of 6787 treatments. As with our prior registry for 2005, information on stem cell infusions was gathered. Information collected included patients demographics, medical history, treatment diagnoses, treatment specifics (type, methodology, access type, anticoagulants, drugs, and equipment usage), side effects, clinical response, and payment provider. As in prior International Apheresis Registries for 1983, 2000, 2002, and 2005, the survey results highlight the regional differences in apheresis usage and treatment methodologies indicating that an international overview of apheresis may be more representative of the impact of this therapeutic modality.

The developments in apheresis technologies and techniques and their clinical applications worldwide are technologically, sociologically, and economically driven. In the past, apheresis survey statistics have highlighted both the differences by geographical region in clinical practices and in the types of technologies utilized. While a national view of apheresis is critically important, an international view of apheresis may be more representative overall of this therapeutic modality than national results that are highly dependent on the local economics and the available technologies. These regional differences have provided a basis for the scientific and clinical assessments of these apheresis technologies and their clinical outcomes and have impacted the marketing and business developments of new technologies worldwide. The results

The developments in apheresis technologies and techniques and their clinical applications worldwide are technologically, sociologically, and economically motivated. In past apheresis surveys the statistics have highlighted both the differences by geographic region in clinical practice and in the types of technologies utilized. While a national view of apheresis is very important, an international view may be more representative overall of this therapeutic modality than national results that are highly dependent on the local economics and the available technologies. These regional differences have provided a basis for scientific and clinical assessment of these apheresis technologies and their clinical outcomes, and have impacted the marketing and business developments of new technologies worldwide. The results of the International Apheresis Registry for 2005 reporting from 22 centers on 5 continents are presented. The survey collected data exclusively via a secure internet website on 1133 patients for a total of 6501 treatments. Unlike our prior registries, information on stem cell infusions was gathered. Information gathered included patient demographics, medical history, treatment diagnoses, treatment specifics (type, methodology, access type, anticoagulants, drugs, and equipment usage), side-effects, clinical response, and payment provider. As in the prior International Apheresis Registries for 1983, 2000, and 2002 the survey results highlight the regional differences in apheresis usage and treatment methodologies, indicating that an international overview of apheresis may be more representative of the impact of this therapeutic modality.

The developments in apheresis technologies and techniques and their clinical applications worldwide are technologically, sociologically, and economically motivated. In past apheresis surveys, the statistics have highlighted both the differences by geographic region in clinical practice and in the types of technologies utilized. While a national view of apheresis is very important, an international view may be more representative overall of this therapeutic modality than national results that are highly dependent on the local economics and the available technologies. These regional differences have provided a basis for scientific and clinical assessment of these apheresis technologies and their clinical outcomes and have impacted the marketing and business developments of new technologies worldwide. The results of the International Apheresis Registry for 2002, reporting on 33 centers on four continents, are presented. The survey collected data, predominantly via an internet website, on 811 patients for a total of 11 428 treatments. Information gathered included patient demographics, medical history, treatment diagnoses, treatment specifics (type, methodology, access type, anticoagulants, drugs, and equipment usage), side-effects, clinical response, and payment provider. As in the prior International Apheresis Registries for 1983 and 2000, the survey results highlight the regional differences in apheresis usage and treatment specifics, indicating that an international overview of apheresis may be more representative of the impact of this therapeutic modality.

Results of the second pilot of the International Apheresis Registry for 1983 involving 37 centers on four continents are presented. This report is a follow-up of the initial pilot reported previously and includes the results of 37 additional centers reporting on 659 patients for a total of 5,780 treatments. The results were collected through a single-page questionnaire. Information gathered included patient demographics, medical history, treatment specifics (type, methodology, access type, anticoagulants, drugs), side effects, response, and payment provider. The data are grouped by regions (East, Europe, and North America). Analysis of the data identifies the regional differences in apheresis usage and treatment specifics, suggesting that an international view of apheresis is more representative of this therapeutic modality than national results, which are highly dependent on the local economics and available technology.

Prions are novel proteinaceous-infectious agents that have been implicated in transmissible spongiform encephalopathies. It is now generally accepted that noninfectious prion proteins are normally produced by the host and may undergo a conformational change to an abnormal, pathologic form, which appears to be responsible for disease symptoms. Many methods of decontamination and sterilization are claimed to be ineffective against prion proteins. Incidences of iatrogenic transmission of prions due to medical devices have been reported, and the recommended clinical practices when handling suspected cases are reviewed. Recent results with a peracetic acid based sterilant indicate that it may be a safe and effective means of prion inactivation on medical devices.

An effective hepatic assist system could serve as a bridge to transplantation or to treat acute or chronic hepatic failure. Early nonbiological approaches focused on the removal of low molecular weight toxins by dialysis or hemoperfusion, such as over charcoals or resins. This approach led to clinical trials that showed varying degrees of success. Introduction of more porous membranes and blood separation technologies stimulated the development of plasma exchange, on-line plasma fractionation technologies with sorbents and membranes, and other schemes of sorbent-blood interactions based on the principles of dialysis and hemofiltration with sorbent perfusion. Although detoxification of blood has improved the prognosis for acute liver failure, key issues of when to initiate treatment and by which method need to be resolved. In chronic liver disease, blood detoxification can be applied in patients intractable to conventional therapies and for some awaiting transplantation to relieve disease symptoms such as pruritus, jaundice, elevated bile acids, hyperbilirubinemia, endotoxemia, and hypercholesterolemia. Although biological support is considered the ideal, nonbiological techniques can be useful because hepatocytes possess a regenerative capacity and temporary support is helpful. Available nonbiological liver support technologies can substitute for select liver functions in acute and chronic disease.

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