摘要:

AbstractWe assessed the bilirubin reduction capacity of three different types of devices in vitro: a high‐permeable membrane column for double‐filtration plasmapheresis (DFP) (Evaflux 2A, Kuraray, Japan), and non‐coated charcoal column for hemoperfusion (HP) (N‐180, Asahi Medical, Japan), and ion‐exchange columns for plasma adsorption (PA) (BR‐350, Asahi Medical, Japan, and B‐001, Kuraray, Japan). A column for DFP reduced the concentration of lowmolecular proteins effectively such as plasma bilirubin and bile acids in an albumin‐dependent manner. A charcoal column adsorbed low‐molecular substances preferentially. But in these two columns, the loss of fibrinogen is a limiting factor for determining the processing plasma volume. Ion‐exchange columns for PA adsorbed bile acids, disconjugated bilirubin, and monoconjugated bilirubin more efficiently compared with delta‐bilirubin and unconjugated bilirubin. Pretreatment of the column with heparin reduced the loss of fibrinogen to less than 10%. We applied the BR‐350 ion‐exchange column in vivo for treatment of three patients with hyperbilirubinemia. After treatment, an alcoholic hepatitis patient with the hepatorenal syndrome (HRS) recovered from acute renal failure. However, in a patient with primary biliary cirrhosis and in a patient with fulminant hepatitis, the decrease of serum bilirubin was transient and no obvious beneficial responses were noted. The capacity and ability of the BR‐350 column to adsorb plasma bilirubin was shown sufficient to treat deeply jaundiced patients, because 4 liters of the plasma of a patient with 108 mg/dl of initial total bilirubin concentration was able to be processed continuously without an obvious decrease in bilirubin adsorption capacity. Therefore, this column in combination with dialysis may be most applicable in lowering serum bilirub

ISSN:0733-2459    

DOI:10.1002/jca.2920050302

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

摘要:

AbstractA therapeutic trial of plasma exchange was performed in 13 patients with documented progressive IgA nephropathy. Comparison of the rate of deterioration in renal function before, during, and after plasma exchange demonstrated significant improvement during plasma exchange. Seven patients had a slowed rate of deterioration by plasma exchange, but achieved a decrease in serum creatinine level. Favourable response was correlated with rapidity of deterioration preplasma exchange (Plt; 0.01) and was apparent within 4 weeks of commencing therapy in those patients who responded. There was no overall difference between the deterioration rates pre‐ and postplasma exchange. In patients in whom creatinine decreased on plasma exchange, the initiation of subsequent dialysis was delaye

ISSN:0733-2459    

DOI:10.1002/jca.2920050303

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

摘要:

AbstractThe removal of specific antibody in experimental animals has been reported to result in a subsequent increase in antibody to levels equal to (rebound) or exceeding those existing prior to removal (overshoot). Anecdotal reports suggest that rebound antibody synthesis after plasmapheresis may occur in humans with autoimmune disorders. We measured the antibody response to 12 pneumococcal polysaccharide antigens in patients with myasthenia gravis (MG) receiving a variety of therapies in order to determine whether the T‐cell‐independent IgG response to these antigens was augmented by plasmapheresis. MG patients receiving no immunotherapy or receiving prednisone had pre‐ and post‐immunization titers similar to those of control patients. MG patients receiving prednisone and chronic plasmapheresis had higher pre‐immunization titers than did other patient groups and had significantly higher post‐immunization titers against multiple pneumococcal serogroups. Aggregate post‐immunization geometric mean titers were more than three‐fold higher in the plasmapheresis group as compared with other MG treatment groups. Enhancement of antibody response by plasmapheresis was abolished by the concomitant administration of azathioprine. Antibody rebound and overshoot after antibody removal may have important implications for the therapy of immune disorders by

ISSN:0733-2459    

DOI:10.1002/jca.2920050304

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

摘要:

AbstractTwo apheresis methods used to collect hematopoietic stem cells from peripheral blood were compared in eight patients with a variety of malignancies. The standard lymphocyte collection method was alternated with the counterflow centrifugation or lymphocyte surge protocol. The number of clonogenic cells (CFU‐GM and BFU‐E), the red cell volume, and the number of mononuclear cells in each collection were assessed as well as the changes in circulating leukocytes, platelets, and blood hemoglobin produced by each apheresis procedure. There was no statistically significant difference found in the number of clonogenic cells collected with either method, but the number of mononuclear cells collected with the standard procedure was significantly higher (P= 0.001). The red cell volume collected with the standard procedure was significantly higher, (P= 0.0001), but corrected for the number of mononuclear cells the difference was not significant. The counterflow centrifugation apheresis produced significantly less thrombocytopenia (P= 0.005). The counterflow centrifugation apheresis procedure used collected fewer mononuclear cells than the standard procedure, however, with less red cell contamination but a comparable number of CFU‐GM and BFU‐E in four hour apheresis procedures. Each collection method resulted in a comparable amount of anaemia and leukopenia but the lymphocyte surge method produced less thrombocytopenia following the col

ISSN:0733-2459    

DOI:10.1002/jca.2920050305

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

摘要:

AbstractThermofiltration, a system of membrane plasmapheresis for LDL apheresis, is used to treat patients with refractory hyperlipidemia. In this system, the separated plasma is warmed to or above physiologic temperature, filtered with a membrane filter, and returned to the patient on‐line. Plasma infusion products are not required.In this study one calculated plasma volume was treated weekly, biweekly, or monthly in patients classified as type II hypercholesterolemic. Reduction and sieving of lipoproteins were evaluated. The reduction ratios of high‐density lipoprotein cholesterol (HDLc) and low‐density lipoprotein cholesterol (LDLc) were 0.30 ± 0.06 and 0.58 ± 0.05, respectively (mean ± S.D.). Sieving coefficients of the plasma filter for HDLc and LDLc were 0.62 ± 0.12 and 0.03 ± 0.02, respectively (mean ± S.D. of 31 treatments).To evaluate the posttreatment recovery the apparent fractional catabolic rates (FCRa) for total cholesterol and LDLc were calculated. FCRa was 0.151 ± 0.06 and 0.148 ± 0.06 day−1for total cholesterol and LDLc, respectively.The ratio of the posttreatment concentration on the seventh day to the concentration immediately pretreatment was found to be significantly higher for HDLc than for LDLc, 0.92 ± 0.8 vs. 0.77 ± 0.1 (mean ± S.D.), due to faster HDLc recovery. The ratio of LDLc/HDLc was lowered for up to 2 weeks af

ISSN:0733-2459    

DOI:10.1002/jca.2920050306

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

ISSN:0733-2459    

DOI:10.1002/jca.2920050307

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

ISSN:0733-2459    

DOI:10.1002/jca.2920050308

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

ISSN:0733-2459    

DOI:10.1002/jca.2920050309

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

ISSN:0733-2459    

DOI:10.1002/jca.2920050301

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY