bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plasma exchange in autoimmune hemolytic anemia (AIHA)
Authors: Silberstein L. E. , Berkman E. M. 
Published: February 2007

AbstractPlasma exchange therapy in autoimmune hemolytic anemia (AIHA) was used in four patients (two with warm hemolytic anemia and two with cold hemolytic anemia). The size of each plasma exchange approximated 1 plasma volume; three consecutive daily exchanges removed 80–90% of the immunoglobulins—immunoglobulin G (IgG) and immunoglobulin M (IgM)—. complement (C3, C4), and reduced antibody titers. Transfusion requirements dramatically decreased after plasma exchange in each case. In two patients, red blood cell (RBC) survival studies were performed to more accurately assess the effect of plasma exchange therapy, since steroid and/or immunosuppressive therapy was given concomitantly. In one case of cold AIHA, homologous 51Cr‐RBC were injected 4 days prior to plasma exchange and repeat injection (same donor) following completion of plasma exchange. The survival curve prior to plasma exchange therapy had a T 1/2 = 7.8 days (r = −0.988) and after plasma exchange therapy had a T 1/2 = 20.4 days (r = −0.925). RBC survival studies using homologous 51Cr‐RBC were also performed in a patient with warm AIHA. The survival curve before plasma exchange had a T 1/2 = 2 days (r = −0.95), and postplasma exchange a T 1/2 = 1.8 days (r = −0.91). Plasma exchange therapy seems to have a beneficial effect in cold rather than warm autoimmune hemolytic anemia.
Pharmacological effects produced by the acute and chronic administration of hydroxyethyl starch
Authors: Mishler John Milton 
Published: February 2007

AbstractCenters throughout the world have utilized various erythrocyte sedimenting macromolecules to improve the collection of neutrophils from normal donors, but in the United States, high‐molecular weight hydroxyethyl starch (HES 450/0.70) is presently the only agent approved by the Food and Drug Administration for use during leukocytapheresis. HES 450/0.70, prepared from a waxy species of either maize or sorghum, is hydrolysed by alpha‐amylase present in the bloodstream following intravenous administration. The major portion (70 to 80%) of the injected dose of HES 450/0.70 is eliminated through the kidneys; a smaller portion (20 to 30%) becomes extravasated, and a minor amount is eliminated through the gastrointestinal tract. If HES 450/0.70 is given as a single 500 ml dose, the erythrocyte sedimentation rate (ESR) will be increased and difficulties in blood typing and crossmatching may be encountered. Concentrations of most blood and plasma components will decrease, usually in direct proportion to the amount of HES 450/0.70 and other fluids administered. Determinations, both of hepatic and of renal function, will remain within normal limits, although the levels of an alpha‐amylase in plasma will become elevated. Serious bleeding complications are normally not observed when the dose of HES 450/0.70 does not exceed 1.0 to 1.5 g/kg body weight. Rarely, anaphylactoid reactions may be encountered. If HES 450/0.70 is given on more than one occasion, and especially if administered over a relatively short period of time, mild untoward effects related to expansion of the plasma volume may occur. When HES 450/0.70 is give chronically, tests of hepatic and renal function remain within normal limits, but certain tests of coagulation may become slightly prolonged. HES 450/0.70 has an excellent record of safety and is highly recommended for use during leukocytapheresis.
Membrane plasma exchange: Principles and application techniques
Authors: Samtleben Walter , Randerson David H. , Blumenstein Matthias , Habersetzer Rupert , Schmidt Baerbel , Gurland Hans J. 
Published: February 2007

AbstractMembrane plasmapheresis was introduced in 1978 as a new method for performing therapeutic plasma exchange. Its principal advantages over traditional techniques include speed, ease of performance, and ready adaptability to clinical centers already performing routine extracorporeal therapy. The appearance of a membrane plasmapheresis circuit (vascular access, anticoagulation, connectology) is similar to that of hemodialysis and especially hemofiltration; the operating protocols (treatment time, filtration rates, pressures, pharmacokinetics) are quite different. Particular attention must be paid to avoiding operating conditions that lead to hemolysis.In clinical use membrane plasma separation is as effective as centrifugal plasma exchange in removing plasma proteins. The sieving coefficients for proteins with a molecular weight (MW) ranging from 67,000 (albumin) to 2,400,000 (β‐lipoprotein) daltons are unity. An exchange of one patient plasma volume has been shown to cause a 55% reduction of the serum levels of intravascular proteins. There are no significant differences between membrane and centrifugal plasmapheresis in substitution fluid requirements (human albumin or fresh frozen plasma), indications for treatment and complications.The next major advance in plasmapheresis technology will almost certainly be development of a “closed loop” circuit in which filtered plasma is treated to remove the offending moiety and returned to the patient. This would eliminate both the cost and the possible side effects of replacement fluid. Membrane‐based systems are already available for removing cryoglobulins or proteins with MW of at least 900,000 daltons.
Use of erythrocytapheresis in the treatment of patients with sickle cell anemia
Authors: Kleinman Steven H. , Hurvitz Carole G. , Goldfinger Dennis 
Published: February 2007

AbstractWe performed exchange transfusions, utilizing the technique of automated erythrocytapheresis, for the treatment of patients with sickle cell anemia. In an attempt to determine guidelines for the use of erythrocytapheresis, we studied the use of this procedure in three distinct clinical situations in nine patients with sickle cell disease. Patients with dangerous complications of sickle cell disease such as acute respiratory distress and priapism responded well to erythrocytapheresis, showing marked improvement within 24–48 hours. Patients with prolonged painful vaso‐occlusive crises showed only variable improvement after erythrocytapheresis therapy, insufficient to justify exposing the patient to the risks of the procedure. Patients treated to decrease the frequency of painful crises demonstrated no prolongation in symptom‐free intervals between crises. Therefore, erythrocytapheresis has its main value in the management of acute, dangerous complications of sickle cell disease.
The function and structure of granulocytes collected using the IBM 2997 separator
Authors: Wood Lucille , Hester Jeane P. , Jacobs Peter 
Published: February 2007

AbstractThe effect of oral methylprednisolone and the sedimenting agent, hydroxyethyl starch, on granulocyte recovery, morphology, and function was studied in a volunteer donor programme. Using the IBM 2997, 10 litres of whole blood were processed, with an average procedure time of 2.4 hours and a collection volume of 300 ml. Donors not receiving methylprednisolone (n = 80) had a mean total granulocyte count of 3.5 × 109/litre (range 1.6–5.3 × 109/litre) and mean granulocyte yields were 1 × 1010 (range 0.2–3.0 × 1010). Those receiving 48 mg oral methylprednisolone 6–8 hours before the procedure (n = 320) had a mean granulocyte count of 6.3 × 109/litre (range 3.2–11.4 × 109/litre) and significantly superior mean granulocyte yields of 2.0 × 10ln (0.3–6.5 × 1010) (P < 0.05). For both groups the mean packed cell volume of 0.08 litre/litre (range 0.02–0.17) and platelet contamination 1.9 × 1011 (range 0.3–5.0 × 1011). In all these procedures, hydroxyethyl starch was added to the blood entering the centrifuge channel. In none of the procedures were any untoward symptoms experienced by the donors. Light microscopy and ultrastructural studies showed no difference between control granulocytes and those collected following the addition of hydroxyethyl starch or after oral methylprednisolone. Similarly, granulocyte function measured with a random migration, chemotaxis. phagocytosis, and intracellular killing was not significantly different between control cells and those exposed to the sedimenting agent or the adrenocorticosteroids (P > 0.10). It is concluded that donor premedication with methylprednisolone significantly enhances granulocyte yields in the presence of hydroxyethyl starch and neither agent has any demonstrable effect on granulocyte morphology or function.
Erythrocyte depletion of ABO‐lncompatible bone marrow
Authors: Sniecinski I. , Henry S. , Ritchey B. , Branch D. R. , Blume K. G. 
Published: February 2007

AbstractBone marrow transplantation results in the infusion of 150 to 360 ml of erythrocytes. While this poses no problem to a recipient of marrow from an ABO‐compatible donor, it clearly represents a serious risk of intravascular hemolysis for the recipient of an ABO‐incompatible marrow. Thus, there is a need for removing incompatible erythrocytes from the marrow preparation. We removed erythrocytes from the marrow preparations by automated centrifugation. The erythrocyte‐depleted marrow (EDM) contained a mean of 5 ml erythrocytes, representing an average reduction of 98%. The mean mononuclear cell recovery was 88%, resulting in a mean infusion of 0.6 × 108 cells/Kg of recipient's body weight in a final average volume of 155 ml. EDM was infused into 22 ABO‐incompatible marrow recipients (21 patients with hematologic malignancies and one patient with aplastic anemia) without clinical evidence of hemolysis. The isohemagglutinin titers of recipients ranged from 4 to 4096 and were not lowered prior to infusion. Engraftment (i.e., recovery of peripheral leukocyte and platelet counts) and incidence of graft versus host disease were similar to those observed in recipients of ABO‐compatible marrow transplantation. Erythrocyte engraftment was significantly delayed in only one patient who had a high isohemagglutinin titer. The post‐transplantation red cell requirement was increased in EDM recipients: 9 units compared to 6 units in ABO‐compatible bone marrow transplanted patients with neither hemolysis nor interference with successful engraftment.
Visual pH monitor for medical column regeneration
Authors: Studebaker J. F. , Debroy J. A. 
Published: February 2007

AbstractA flow‐through cartridge for indicating acidic and basic conditions during acid regeneration of immunoadsorption columns is described. Based on a pH dye covalently bound to polyacrylamide beads, it offers a direct visual indication of whether the pH of a column is in a range which is safe for use. The device, mounted in the waste line, may be reused several times.
Plasma exchange in six patients with advanced cancers of the head and neck
Authors: Seder Richard H. , Katz Arnold E. , Keggins John J. , Blanchard G. C. , Oh S. K. , Berman Leonard D. , Vaughan Charles W. , Hong Waun Ki , Strong M. Stuart 
Published: February 2007

AbstractSix patients with advanced squamous cell cancers of the head and neck, with serum IgA ≤ 400 mg/dl and IgE ≥ 1000 IU/ml. underwent a trial of six 2‐liter plasma exchanges over a 2–3‐week period. Disease progressed in patients 1. 2. and 4. who died on days 44. 72. and 159. The tumor in patients 3 and 6 regressed significantly. repeatedly in patient 3 over each of four courses of apheresis. Tumor recurred in both patients after cessation of treatment, and they died at days 420 and 79. Patient 5. with inoperable disease, received full‐dose radiotherapy immediately following the course of apheresis. and showed complete response in the primary lesion and a major response in the extensive lymph node metastases, dying on day 421 of apparently unrelated causes. Serum IgE in the three patients experiencing tumor regression rose paradoxically during plasmapheresis. Only patient 3 had an elevated level of soluble E‐receptor suppressor factor prepheresis: the serum of patient 6 was lymphocytotoxic prepheresis but this activity decreased or disappeared during each of the exchanges studied. Controlled trials are now indicated.
Guidelines for apheresis personnel ‐ an overview
Authors: Cole Barbara 
Published: February 2007

AbstractThe Guidelines for Apheresis Specialists were prepared by the Standards Committee of the Society of Hemopheresis Specialists (SHS) in response to a need to safeguard donors and patients undergoing apheresis from the viewpoint of the technical staff performing the procedures. The Guidelines address technical and administrative topics not covered by instrument manufacturer's training sessions and manuals. The Guidelines contain the following objectives:

To assure that apheresis procedures are performed and supervised by qualified personnel, thereby safeguarding the donors, patients and recipients of the components harvested.
To assure that apheresis procedures are carried out in a safe, efficient and appropriate manner with minimum risk and maximum benefit.
To assure donor/patient safety and high quality component preparation through an effective quality control program.
The Guidelines are flexible, adaptable to various physical settings, applicable to different types of instruments, and useful for both therapeutic and donor hemapheresis procedures. They avoid references to issues that may be considered to interfere with internal or external policymaking bodies. In addition, they provide a base from which policies and procedures can be formulated and amended to account for advances in technology and expertise.
Plasma exchange and prednisone in acute inflammatory polyradiculoneuropathy: A controlled randomized trial
Authors: Mendell J. R. , Kissel J. T. , Kennedy M. S. , Sahenk Z. , Grinvalsky H. T. , Pittman G. L. , Kyler R. S. , Roelofs R. I. , Whitaker J. N. , Bertorini T. E. 
Published: February 2007

AbstractA controlled‐randomized trial of plasma exchange combined with prednisone was compared to supportive care alone in patients with acute inflammatory polyradiculoneuropathy (AIP). The design of this study differs from other reported trials of plasma exchange in AIP because prednisone was used in the treatment group to prevent the possibility of antibody rebound. Furthermore, in this study, detailed muscle strength testing formed the principal basis for assessment of therapeutic efficacy while in the British, North American, and French studies, a functional assessment scale was used. Analysis of our data revealed no significant improvement in the treated group over the controls. The sample size, albeit small (12 treated and 13 controls), had the power (95% chance) to detect a change of two British Medical Research Council grades of strength between the groups. The difference in our results versus others (North American and French studies) probably reflects the adverse effects of prednisone on recovery in AIP. An additional consideration is that plasma exchange may have an overall modest effect on the course of AIP, less appreciated when individual muscles are tested compared to assessment by large functional categories.
Apheresis in the treatment of chronic relapsing polyneuropathy
Authors: Handelsman Harry 
Published: February 2007

AbstractAs a distinct inflammatory demyelinating disease, chronic relapsing polyneuropathy can be extremely debilitating and cause respiratory failure leading to death. The cause of the disorder is unknown, although evidence suggests that immune dysfunction plays some role in its pathogenesis.Conventional treatment using steroids and immunosuppressants has been reported both as effective and ineffective in controlling the course of the disease. The rationale for apheresis, as a nonspecific therapy, is related to the removal and/or dilution of circulating cytotoxic factors, and some patients have achieved dramatic and sometimes prolonged remissions from such treatments.Existing evidence from a large and growing number of case reports suggests that apheresis is a reasonable treatment for patients with severe or life‐threatening symptoms which fail to respond to conventional therapy. However, convincing data of its efficacy is lacking and must await the results of appropriate randomized clinical trials.
Plasmapheresis: An adjunct to medical management of severe hyperthyroidism
Authors: Braithwaite Susan S. , Brooks Marion H. , Collins Sonia , Bermes Edward W. 
Published: February 2007

AbstractA woman with hyperthyroidism and myasthenia gravis developed respiratory failure in association with radiation‐induced thyroiditis. Treatment with steroids, propylthiouracil, propranolol, iodine, and plasmapheresis was associated with dramatic reduction in serum triiodothyronine (T3), serum thyroxine (T4), and thyroglobulin levels and prompt recovery of the patient. The medications that this patient received have been shown to cause an abrupt decline in serum T3 levels with little or no effect on the serum T4 concentration. The 56% decline in serum T4 observed in this patient during the first 24 hours of therapy suggests that plasmapheresis may be a useful adjunct to medical therapy in selected patients with severe hyperthyroidism.
Implementation of a semiclosed large scale counterflow centrifugal elutriation system
Authors: Gao Ino K. , Noga Stephen J. , Wagner John E. , Cremo Carol A. , Davis Janice , Donnenberg Albert D. 
Published: February 2007

AbstractA semiclosed counterflow centrifugal elutriation system that minimizes the risks of contamination and cell loss is presented. A detailed description of the configuration of the system and its sterilization and assembly is provided along with examples of its application to large‐scale separation of leukapheresis buffy coat and cadaveric bone marrow. We are currently using this system to deplete lymphocytes from human bone marrow prior to use in allogeneic bone marrow transplantation. The implementation of a semiclosed system increases the safety, ease of operation, and reproduciblity of a technique that has the potential for a wide range of clinical applications.
Plasma exchange and plasma modification for the removal of anti‐red cell antibodies prior to abo‐incompatible marrow transplant
Authors: Bensinger William I. , Buckner C. Dean , Clift Reginald A. , Thomas E. Donnall 
Published: February 2007

AbstractPlasma exchange (PE) is performed only rarely to remove a specific, well defined antibody. ABO incompatibility in marrow transplantation has allowed us a unique opportunity to compare the effectiveness of three apheresis procedures for removing anti‐red cell antibodies. We performed 140 marrow transplants in which a major ABO incompatibility between donor and recipient existed. To avoid a hemolytic transfusion reaction at the time of marrow infusion PE, plasma immunoadsorption (PIA) or whole‐blood immunoadsorption (WBIA) was performed a total of 243 times. PE removed a mean of 87% of intravascular IgM and 86% of intravascular IgG directed against red cell antigens. PIA removed 75% and 73% of IgM and IgG, respectively (P < .001 when compared to PE). Results for WBIA were 66% and 65%, respectively. Thus, PIA and WBIA were less efficient at removing antibody than PE. Furthermore, there were a few specific instances in which PIA or WBIA removed little or no antibody owing to differences in antibody specificity. PIA and WBIA resulted in less platelet consumption than PE. Although somewhat less effective that PE, PIA and WBIA have other advantages that can make them more desirable.
Use of autologous pregnancy plasma to treat a flare of juvenile rheumatoid arthritis: Case report and literature review
Authors: Wallace Daniel J. , Goldfinger Dennis , Klinenberg James R. 
Published: February 2007

AbstractA patient with juvenile rheumatoid arthritis whose disease was in remission during pregnancy underwent third‐trimester plasmaphereses. The stored plasma was returned to her 1 year postpartum, when the disease flared, without beneficial results. The literature on the use of blood products in rheumatoid arthritis and pregnancy is reviewed.
Rapidly progressive glomerulonephritis associated with amyloidosis: Efficacy of plasma exchange
Authors: Vernier I. , Pourrat J. P. , Mignon‐Conte M. A. , Hemery M. , Dueymes J. M. , Conte J. J. 
Published: February 2007

AbstractThis report describes one case of rapidly progressive glomerulonephritis associated with amyloidosis in a 53‐year‐old woman with rheumatoid arthritis, successfully treated with intensive plasma exchange and immunosuppression. Amyloid deposits were present in all of 20 glomeruli in the kidney biopsy specimen and eight out of nine nonfibrosed glomeruli contained crescents. With intensive plasma exchange and immunosuppressive drugs, renal function improved, and hemodialysis was discontinued. After 2 years, renal function was stable at a moderate level of impairment, but heavy proteinuria persisted.
Benefit of a 37°C extracorporeal circuit in plasma exchange therapy for selected cases with cold agglutinin disease
Authors: Andrzejewski C. , Gault E. , Briggs M. , Silberstein L. 
Published: February 2007

AbstractPlasmapheresis is commonly advocated in cold agglutinin disease with life‐threatening hemolysis. Some clinicians, however, are reluctant to use this therapy because of perceived technical problems and risks attendant with the temperature of the extracorporeal circulation. In this study we report our experience of two patients with severe life‐threatening hemolysis and in whom plasma exchange was not feasible due to red blood cell autoagglutination in the extracorporeal circuit. A method is described involving the use of blood warmers and the Fenwal CS‐3000 blood cell separator with its 37 °C centrifuge compartment. The use of plasma exchange in this manner is a safe and beneficial form of adjunctive therapy and should be considered for patients with cold agglutinin disease at risk for extracorporeal agglutination or hemolysis.
Hypercholesterolemia and atherosclerosis: Present and future therapy including LDL‐apheresis
Authors: Kottke Bruce A. , Pineda Alvaro A. , Case Marvin T. , Orsuzar Alyce M. , Brzys Karen A. 
Published: February 2007

AbstractAtherosclerosis‐induced coronary heart disease remains the major cause of death and disability in industrialized countries. Hypercholesterolemia is recognized as a causative factor in the development of atherosclerosis. While the lowering of cholesterol levels as a treatment goal has met with general agreement and acceptance, the preferred methods for doing so are still open to conjecture. This literature review discusses various factors in the hypercho‐lesierolemia‐atherosclerosis link and surveys a variety of treatment protocols including diet modification, drug therapy, surgical intervention, and plasmapheresis. Evidence is accumulating to prove that the ideal hypercholes‐terolemia therapy is one that reduces LDL levels while maintaining or increasing HDL levels. Because LDL‐apheresis has this potential, this paper also reviews the various LDL‐apheresis methods, including immunoadsorp‐tion, chemical affinity,' and double‐membrane filtration.