Double filtration plasmapheresis utilizing new membrane technology

鉄三, 阿岸; 岩和, 金子; 良博, 蓮尾; 孜, 佐中; 尚美, 須藤; 勇太郎, 早坂; 和夫, 太田; 道夫, 安部; 俊彦, 小野; 収治, 川井; 忠之, 山根

doi:10.4009/jsdt1968.14.61

Cited by 3 publications

(7 citation statements)

References 6 publications

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“…DFPP is a procedure, designed to selectively remove serum immunoglobulins without removing much of plasma components. [ 5 ] Since its invention by Agishi et al ., it has been used for diverse indications, but only a few studies had analyzed the efficiency of removal of target plasma molecules and its complications. [ 5 6 ] Knowledge of the same is extremely important, as it helps to use it for appropriate indications while minimizing complications.…”

Section: Discussionmentioning

confidence: 99%

“…showed that there is significant removal of serum immunoglobulins, but assessment of the efficiency of removal in serial treatment sessions was not elaborated, and replacement fluids were either not used or used minimally. [ 5 ] Tanabe showed that the percentage of removal of IgM and IgG per session was 70% and 60%, respectively, with 8% albumin used as a replacement solution. [ 6 ] Hebibi et al ., on the other hand, showed the suboptimal removal of serum IgG, IgA, IgM (37.8%, 52.8%, and 61.5%, respectively) and one of the major reasons could be not using the replacement solutions during the procedure.…”

Section: Discussionmentioning

confidence: 99%

“…initially described the procedure without replacement solution. [ 5 ] Subsequently, many others including Tanabe started using 7.5% albumin as replacement solution which roughly contains the albumin content of 2.5 – 3 l of plasma. [ 6 ] Nishi et al .…”

Section: Discussionmentioning

confidence: 99%

“…DFPP, is a method of selective plasmapheresis, pioneered by Agishi et al . in Japan (in the 1980's),[ 5 ] for desensitization in blood group incompatible renal transplantation. Over time, it has been used for diverse indications.…”

Section: Introductionmentioning

confidence: 99%

“…Filtered plasma is allowed to pass through a second filter, which is called “plasma fractionator,” that allows smaller molecules to pass through back into circulation and discards other molecules which are large than the pore size of the fractionator. [ 5 ]…”

Section: Introductionmentioning

confidence: 99%

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Effect of double filtration plasmapheresis on various plasma components and patient safety: A prospective observational cohort study

Jagdish¹,

Jacob²,

Varughese³

et al. 2017

Indian J Nephrol

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Double filtration plasmapheresis (DFPP) was historically used for blood group incompatible renal transplantation. Very few studies are available worldwide regarding its efficiency in removing specific plasma components, and safety. We conducted a prospective observational cohort study over 1 year on patients undergoing DFPP for various renal indications. There were 15 patients with 39 sessions. The pre- and post-procedure plasma samples of serum IgG, IgA, IgM, fibrinogen, calcium, phosphate, potassium, and magnesium were analyzed. The effluent albumin concentration was also measured, and complications during the hospital stay were recorded. Cumulative removal of serum IgG, IgA, IgM, fibrinogen, and albumin at the end of four sessions were 72%, 89%, 96%, 88.5%, and 21.3%, respectively and effluent albumin concentration was 1.75 – 2.0 times (range: 6.3 g/dl – 7.2 g/dl; mean ± standard deviation (SD) – 7 g/dl ± 0.3 g/dl) the preprocedural serum albumin (mean ± SD – 3.5 g/dl ± 0.5 g/dl). Removal of other plasma components were not statistically significant. Hypotensive episodes were observed only 16.6%, with the usage of effluent concentration albumin as replacement fluid despite an average 2.4 (mean ± SD – 2.4 ± 0.4 l) liters of plasma volume processing each session. DFPP removes IgG, IgA, IgM, fibrinogen, and albumin. The cumulative removal IgG (72%) is suboptimal, whereas IgA (89%) and IgM (96%) are comparable to historical controls. We observed lesser episodes (12.5%) of hypotension with effluent albumin concentration as replacement fluid, and all bleeding complications were observed when serum fibrinogen level was <50 mg/dl.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effect of double filtration plasmapheresis on various plasma components and patient safety: A prospective observational cohort study

Jagdish¹,

Jacob²,

Varughese³

et al. 2017

Indian J Nephrol

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Double filtration plasmapheresis for children with different types of critical kidney diseases: a single-center retrospective cohort study

Quan¹,

Chen²,

Yang³

et al. 2023

Transl Pediatr

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Background: Double filtration plasmapheresis (DFPP) was initially used to facilitate the conduction of ABO-incompatible renal transplantation. The applicability of DFPP has recently expanded to cover the removal of various antibodies in adults with immune-mediated diseases. However, DFPP is seldom used in children, with few reports addressing its efficacy and safety in this population. This study aimed to explore the efficacy and adverse effects of DFPP for pediatric patients with renal indications.Methods: Children who received DFPP between December 2017 and December 2020 at Tongji Hospital were retrospectively studied, and sub-grouped for analysis according to the types of disease. All children received 3 to 6 DFPP sessions within 2 to 3 weeks, and were assessed for clinical outcomes according to glomerular filtration rate, proteinuria and extra-renal symptoms. Pre-and post-DFPP plasma were collected to measure the levels of pathogenic autoantibodies, immunoglobulins, fibrinogen, albumin, calcium, etc. Inhospital complications were also recorded.Results: Totally there were 10 children receiving 44 sessions of DFPP, including 2 males and 8 females, with a median age of 11.2 years old (5-13 years) and a median weight of 42.1 kg (20-59 kg). Five patients were treated for systemic lupus erythematosus (SLE), three patients for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), one for C3 glomerulopathy and one for ABO-incompatible renal transplantation. Plasma autoantibodies decreased substantially by 93% and 89% in those with SLE and AAV after the last session, respectively. Complete or partial responses were achieved in 80%, 33.3%, 100% and 100% of patients with SLE, AAV, C3 glomerulopathy, and ABO-incompatible renal transplantation, respectively. The proportion of cumulative IgG, fibrinogen, and albumin removal at the end of the last sessions were 58.8%, 67.69%, and 14.05% respectively. The removal of calcium, potassium and creatinine were not statistically significant. A few episodes (4.55%) of hypotension were observed when fresh frozen plasma was used as the replacement fluid, and no bleeding nor severe anaphylaxis was noted. Conclusions:The efficacy and safety of DFPP treatment in children with SLE, AAV, C3 glomerulopathy and ABO-incompatible renal transplantation were described in the present study. DFPP is proven to be a safe apheresis method for children weighing more than 20 kg.

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Role of double-filtration plasmapheresis in ABO- and human leukocyte antigen-incompatible kidney transplant

Mandal

Sinha²,

Kabra³

et al. 2022

Glob J Transfus Med

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Double filtration plasmapheresis utilizing new membrane technology

Cited by 3 publications

References 6 publications

Effect of double filtration plasmapheresis on various plasma components and patient safety: A prospective observational cohort study

Effect of double filtration plasmapheresis on various plasma components and patient safety: A prospective observational cohort study

Double filtration plasmapheresis for children with different types of critical kidney diseases: a single-center retrospective cohort study

Role of double-filtration plasmapheresis in ABO- and human leukocyte antigen-incompatible kidney transplant

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