Panel II: Dosage and scheduling regimens for erythrocyte‐sedimenting macromolecules

Washout kinetics of colloidal starch as a partial or full replacement for plasma exchange

“…Adverse reactions to colloidal starch are infrequent (Mishler et al, found 40 in 566,755 infusions or 0.007%) and are typically transient, mild, and clinically insignificant [9]. However, occasional "lifethreatening reactions do occur (Mishler et al, found three in 566,755 infusions or <O.OO 1 %), but the association of such serious reactions with the starch infusion is sometimes in question [9,10]. Rarely, severe pruritis has been reported that occurs 2-3 weeks following the infusion of several liters of HES within approximately 1 week.…”

Partial colloid starch replacement for therapeutic plasma exchange

“…Approximately 30-40% of the HES is eliminated by the kidneys within 24 hours. However, the larger molecular weight molecules, are not cleared by the renal glomeruli and remain in the circulation for many weeks [7,8,10,11]; therefore they are subject to mechanical removal during subsequent TPEs.…”

“…The maximum dose and/or frequency of HES infusion has never been established. In 1983, a panel of experts recommended a maximum HES dose for leukaphesis donors [8]. This recommendation allowed for 500 ml of 6% HES (one dose) every 8 weeks with a maximum of six doses in a year; or in the case of family member donors, up to four daily or alternate day doses with a maximum of 12 doses in a year with 6-12 month interval between series of donations.…”

Alternatives to albumin: Starch replacement for plasma exchange

“…Adverse reactions to colloidal starch are infrequent (Mishler et al, found 40 in 566,755 infusions, or 0.007%) and are typically transient, mild, and clinically insignificant [6]. However, occasional ''life threatening'' reactions do occur (Mishler et al, found three in 566,755 infusions or <0.001%), but the association of such serious reactions with the starch infusion is sometimes in question [13,14].…”