Plasma extraction rate and collection efficiency during therapeutic plasma exchange with Spectra Optia in comparison with Haemonetics MCS+

Abstract

For therapeutic plasma exchange (TPE), continuous and intermittent flow separators are known to be efficient. This study was undertaken to compare the performances of the Spectra Optia, a continuous flow centrifugal apheresis system recently developed by CaridianBCT, with the Haemonetics Multicomponents System (MCS)+ apheresis system based on intermittent flow centrifugation. The primary objective of the study was to compare the time required to exchange one total plasma volume with both separators. The secondary objectives were to determine the plasma exchange efficiency, the plasma extraction rate, the percentage of target exchange volume achieved, and the loss of cellular components. The study involved prospectively paired comparison of 16 TPE on each device performed in patients with chronic diseases treated with TPE. The time required to exchange 1 total plasma volume was 182 ± 36 minutes for MCS+ procedures and 100 ± 20 minutes for the Spectra Optia procedures (P < 0.05, all results presented as mean ± standard deviation). A significantly higher plasma extraction rate was achieved (30.2 ± 4.3 vs 16.8 ± 3.4 mL/min, respectively, P < 0.05), and the plasma exchange efficiency was slightly better with the Spectra Optia compared with the MCS+ procedures (83.4 ± 7.0 vs 80.0 ± 8.5%, P < 0.05). The platelet loss was significantly lower with the Spectra Optia compared with the MCS+ procedures (1.6 ± 2.3 vs 7.5 ± 4.2%, respectively, P < 0.05), whereas the red blood cells loss was comparable. In conclusion, the Spectra Optia has significantly higher extraction rate and exchange efficiency than the MCS+ allowing to remove the same amount of plasma in less time, by processing less blood. It also removes significantly less platelets than the MCS+ separator.

Comparison of plasma exchange performances between Spectra Optia and COBE Spectra apheresis systems in repeated procedures considering variability and using specific statistical models

“…For instance the mean PRE obtained after CSP devices in previous studies ranged from 69% to 79% [4,9,10] and the mean PRE observed after CSP in our study (76%) was in accordance with these results. The mean PRE observed after SPO in our study (79%) was lower than the mean PRE observed in previous studies (84-87%), which could be explained by the higher average blood flow rate in our study and the higher PVs processed in these studies [4,5]. Secondary outcomes as the amounts of ACD-A consumed apheresis duration platelets losses in the waste bags and consequences on the patients' blood were compared in the SPO and CSP sessions.…”

“…This study demonstrated that the performances of the SPO improved compared to the performances of CSP and showed no occurrence of significant adverse events [4]. Another group compared the efficiency of the SPO to the efficiency of the MCS+ and showed that the time required to exchange one total plasma volume was shorter when using the SPO and that the performances obtained with the SPO characteristics (mainly analysed using the plasma extraction rate) improved compared to performances obtained with the MCS+ [5].…”

“…Combined with the efficiency of the devices the duration of the TPE sessions could be considered as an important outcome for apheresis teams. Then the duration required to exchange a target volume was considered as a primary objective in the study comparing the efficiency of the SPO to the efficiency of the MCS+ [5]. The results of this study showed a mean duration significantly reduced with SPO compared to MCS+ [5].…”

Spectra Optia apheresis system: experience with secondary plasma devices

“…The Optia is also designed to achieve high plasma extraction rates even at low inlet blood flows and peripheral venous access. 17 To prevent clotting, especially in the case of IA with low inlet blood flow, mixed anticoagulation with heparin is helpful. In 1999, Braun and Risler described anticoagulation for IA.…”

Successful Pretreatment Using Plasma Exchange before Thyroidectomy in a Patient with Amiodarone-Induced Thyrotoxicosis

“…Preoperatively, therapeutic plasma exchange (TPE) was performed with the Spectra OPTIA ® apheresis system, to prevent thyroid storm and potential cardiac complications. The Spectra OPTIA device performs a continuous separation through centrifugation and plasma exchange, resulting in high plasma exchange efficiency (80%) [7] . TPE was performed daily and 1-1.5 plasma volumes were exchanged during every procedure.…”