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Journal of Clinical Apheresis

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https://www.readbyqxmd.com/read/30414332/a-case-review-of-a-patient-experience-of-photopheresis-using-a-peripherally-inserted-central-catheter
#1
Cherie Rushton, Andrew Jackson, Kathryn Goddard, Arun Alfred
Extracorporeal photopheresis (ECP) is a cell based immunomodulatory therapy in which the patient is attached intravenously to a cell separating machine. During ECP a patient's blood is collected via either a central venous access device (CVAD) or a peripherally inserted 16G arterial venous fistula needle in either one or both antecubital fossa. However, patients presenting for ECP with GVHD repeatedly present a challenge to the ECP team due to poor venous access resulting from previous therapies and skin changes...
November 10, 2018: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/30407662/granulomonocytapheresis-as-a-cell-dependent-treatment-option-for-patients-with-inflammatory-bowel-disease-concepts-and-clinical-features-for-better-therapeutic-outcomes
#2
REVIEW
Abbi R Saniabadi, Tomotaka Tanaka, Takayuki Yamamoto, Wolfgang Kruis, Rodolfo Sacco
Ulcerative colitis (UC) and Crohn's disease (CD) are major phenotypes of the chronic inflammatory bowel disease (IBD), which afflicts millions of individuals throughout the world with debilitating symptoms. The chronic nature of IBD means that patients require life-long medications, and this may lead to drug dependency, loss of response together with adverse side effects as additional morbidity factors. The efficacy of antitumour necrosis factor (TNF)-α biologics has validated the role of inflammatory cytokines notably TNF-α in the exacerbation and perpetuation of IBD...
November 8, 2018: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/30407658/influence-of-vascular-access-devices-upon-efficiency-of-therapeutic-plasma-exchange
#3
Thomas Ritzenthaler, Mickael Beraud, Florent Gobert, Frédéric Dailler
BACKGROUND: An efficient vascular access is mandatory for the proper conduction of therapeutic plasma exchanges (TPE). Peripheral and central venous catheters may be used, with respective advantages and limitations. In this study, vascular access devices (IV catheter, dialysis cannula, central venous catheter) and anatomic vein characteristics were evaluated. METHOD: From January to June 2016, 162 TPE in 29 patients were reviewed. Only TPE using centrifugation method (Spectra Optia apheresis system) were evaluated...
November 8, 2018: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/30407650/plasma-exchange-for-heparin-induced-thrombocytopenia-in-patients-on-extracorporeal-circuits-a-challenging-case-and-a-survey-of-the-field
#4
Joseph H Cho, Megan Parilla, Angela Treml, Geoffrey D Wool
Current management of heparin-induced thrombocytopenia (HIT) involves prompt discontinuation of all heparin products and concomitant initiation of a direct thrombin or anti-Xa inhibitor for anticoagulation. In the setting of HIT complicated by an urgent need for cardiopulmonary bypass (CPB), the safety and the efficacy of short-term heparin-based anticoagulation after therapeutic plasma exchange (TPE) have been previously demonstrated. Patients with HIT requiring TPE are frequently on extracorporeal circuits (either CPB, extracorporeal membrane oxygenation [ECMO] or external ventricular assist devices [VADs])...
November 8, 2018: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/30394580/adamts13-kinetics-after-therapeutic-plasma-exchange-and-plasma-infusion-in-patients-with-upshaw-schulman-syndrome
#5
Petra Kovarova, Radomira Hrdlickova, Sarka Blahutova, Zuzana Cermakova
BACKGROUND: Hereditary thrombotic thrombocytopenic purpura, also called Upshaw-Schulman syndrome (USS), is a rare disease caused by genetic mutations in the ADAMTS13 gene, which severely decrease the activity of ADAMTS13, a metalloprotease that cleaves von Willebrand factor multimers (VWF). Genotypically identical patients can show great phenotypic diversity. OBJECTIVES: Comparison of selected laboratory parameters and ADAMTS13 pharmacokinetics among patients with USS was performed...
November 5, 2018: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/30394564/favorable-impact-of-extracorporeal-photopheresis-in-acute-and-chronic-graft-versus-host-disease-prospective-single-center-study
#6
Ioanna Sakellari, Eleni Gavriilaki, Ioannis Batsis, Despina Mallouri, Alkistis-Kira Panteliadou, Andriana Lazaridou, Anna Vardi, Varnavas Constantinou, Evangelia Yannaki, Apostolia Papalexandri, Panayotis Kaloyannidis, Christos Smias, Achilles Anagnostopoulos
BACKGROUND: Graft vs host disease (GVHD) is the most severe complication of allogeneic hematopoietic cell transplantation. Conventional immunosuppressive therapy increases morbidity and mortality without improving survival. Extracorporeal photopheresis (ECP) has been introduced as an alternative treatment in steroid-dependent and steroid-refractory disease. STUDY DESIGN AND METHODS: We studied the safety and efficacy of ECP as a second- or third-line treatment in GVHD...
November 5, 2018: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/30387237/indwelling-ports-for-prophylactic-rbc-exchanges-in-sickle-cell-patients-comparison-of-bard-and-vortex-ports
#7
Shaun Lawicki, Laura Craig-Owens, Peter R Bream, Quentin Eichbaum
INTRODUCTION: Red blood cell exchange (RCE) procedures are commonly used for stroke prevention in sickle cell disease (SCD) patients. We compared two different dual lumen ports used for RCE because differences between the port and catheter design may lead to functional variance. METHODS: We reviewed the RCE parameters of SCD patients following implantable port placement encountered at a single institution. Five Vortex and four Bard ports were used and compared. Patients were followed for 1-24 exchange procedures over 3-26 months performed between 2013 and 2015...
November 2, 2018: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/30387202/patient-consultation-about-a-trial-of-therapeutic-plasma-exchange-for-complex-regional-pain-syndrome
#8
Andreas Goebel, Therese Callaghan, Sandra Jones, John Bridson
BACKGROUND: Complex regional pain syndrome (CRPS) is a severe post-traumatic chronic pain condition affecting distal limbs, for which few effective treatments exist. Complex regional pain syndrome is listed in the 2016 American Society for Apheresis guidelines as an indication for plasma exchange treatment, but patient perspectives are lacking. STUDY DESIGN AND METHODS: We convened a "patient and public consultation exercise." Supervised by a clinical ethicist, the case for using therapeutic plasma exchange (TPE) was presented by a researcher and two TPE experts to five patients with severe, long-standing CRPS and to one relative...
November 2, 2018: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/30387199/single-needle-an-effective-alternative-to-dual-needle-peripheral-access-in-therapeutic-plasma-exchange
#9
Betty M Doggett, Nellie Session-Augustine, Joseph Roig, Matthew Strunk, Shiney Valiyaparambil, Ravi Sarode, Nicole De Simone
Apheresis treatments, which involve the removal of a component of blood, generally require one access and one return line to continuously draw and return blood into the extracorporeal circuit. At our center, we prefer to use peripheral venous access to avoid central line-related complications, especially infection. Motivated by patient-centered care, the single-needle (SN) option for therapeutic plasma exchange (TPE) offered on the Spectra Optia (Terumo BCT, Lakewood, CO) was evaluated. Five patients underwent procedures using both SN and dual-needle (DN) plasma exchange procedures using the Spectra Optia...
November 2, 2018: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/30387186/red-blood-cell-exchange-in-treatment-of-severe-cerebral-p-falciparum-malaria-a-case-report
#10
Joshua T Genstler, Amir Abdipour
INTRODUCTION: Red blood cells exchange transfusion has been demonstrated to be helpful in treatment of sever P. falciparum malaria. However, no large scale randomized controlled trials have been completed to date and the CDC does not recommend RBC exchange transfusions as standard of care. We present a case of severe cerebral malaria in a patient with extremely high parasitemia and severe altered mental status who improved rapidly with automated RBC exchange. REPORT: Seventy-two year old female presented with 1 day history of weakness, altered mental status, malaise, and cyclic sweats after returning from a trip to Sierra Leone...
November 2, 2018: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/30375048/hemostasis-testing-and-therapeutic-plasma-exchange-results-of-a-practice-survey
#11
Nicole D Zantek, Monica B Pagano, Marian A Rollins-Raval, Roy E Smith, Amy E Schmidt, Jason E Crane, Leonard I Boral, Yanhua Li, Annika M Svensson, Chisa Yamada, Yanyun Wu, Edward C C Wong
INTRODUCTION: Performing therapeutic plasma exchange (TPE) with albumin replacement decreases coagulation factor and platelet levels. No defined guidelines exist regarding laboratory testing to assess hemostasis in patients undergoing TPE. MATERIALS AND METHODS: A survey to evaluate hemostasis testing with TPE was distributed using online survey software. One response per institution was analyzed based on a hierarchical algorithm, excluding membrane filtration users, resulting in a maximum of 120 respondents per question...
October 30, 2018: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/30329175/cost-minimization-analysis-in-the-indian-subcontinent-for-treating-guillain-barre-syndrome-patients-with-therapeutic-plasma-exchange-as-compared-to-intravenous-immunoglobulin
#12
Ashish Maheshwari, Ratti R Sharma, Shankar Prinja, Rekha Hans, Manish Modi, Navneet Sharma, Neelam Marwaha
BACKGROUND: Therapeutic Plasma Exchange (TPE) and Intravenous Immunoglobulin both are first-line treatments for Guillain Barre Syndrome; however, there is a significant difference in cost. We undertook this study to assess the cost minimization for treating Guillain Barre Syndrome patients. METHODS: A prospective randomized controlled trial was undertaken, in which 40 Guillain Barre Syndrome (GBS) patients with a GBS disability score of grade four and five were enrolled...
October 17, 2018: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/30321468/weathering-the-storm-a-case-of-thyroid-storm-refractory-to-conventional-treatment-benefiting-from-therapeutic-plasma-exchange
#13
Aaron J Wyble, Steven C Moore, Sean G Yates
Thyroid storm is a severe manifestation of thyrotoxicosis characterized by systemic organ dysfunction secondary to a hypermetabolic state. Although antithyroid drugs, steroids, beta-blockers, antipyretics, and cholestyramine are the standard of care, some patients inadequately respond to these conventional therapies. Therapeutic plasma exchange has been previously utilized as a treatment modality in patients with a poor response to routine therapies or with contraindications to them. Herein, we report our experience with the management of a case of thyroid storm refractory to conventional treatment but responsive to therapeutic plasma exchange...
October 15, 2018: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/30321467/efficacy-of-therapeutic-plasma-exchange-on-angiotensin-ii-type-1-receptor-antibodies-on-two-kidney-transplant-recipients
#14
Chisa Yamada, Yihung Huang, Silas Norman, Abhijit Naik, Omar Moussa, Milagros Samaniego, Laura Cooling
BACKGROUND: Angiotensin II type-1 receptor antibody (AT1RAb) has been reported to cause antibody mediated rejection (AMR) in kidney transplant recipients possibly by contraction of renal arteries. We here report 2 kidney transplant recipients with elevated AT1RAbs and negative HLA donor specific antibodies (DSA) and anti-major histocompatibility complex class I chain-related gene A (MICA) Abs who received therapeutic plasma exchange (TPE) treatment followed by IVIG. CASE 1: Thirty-eight-year-old patient received second kidney transplant for end stage renal disease (ESRD) with chronic rejection...
October 15, 2018: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/30321466/therapeutic-plasma-exchange-as-a-novel-treatment-for-severe-intrahepatic-cholestasis-of-pregnancy-case-series-and-mechanism-of-action
#15
Caroline Ovadia, Anita Lövgren-Sandblom, Lindsey A Edwards, Jacqueline Langedijk, Victoria Geenes, Jenny Chambers, Floria Cheng, Louise Clarke, Shahina Begum, Muna Noori, Charles Pusey, Radhika Padmagirison, Sangita Agarwal, James Peerless, Kate Cheesman, Michael Heneghan, Ronald Oude Elferink, Vishal C Patel, Hanns-Ulrich Marschall, Catherine Williamson
INTRODUCTION: Intrahepatic cholestasis of pregnancy is characterised by pruritus and elevated serum bile acids. The pruritus can be severe, and pharmacological options achieve inconsistent symptomatic improvement. Raised bile acids are linearly associated with adverse fetal outcomes, with existing management of limited benefit. We hypothesised that therapeutic plasma exchange removes pruritogens and lowers total bile acid concentrations, and improves symptoms and biochemical abnormalities in severe cases that have not responded to other treatments...
October 15, 2018: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/30321453/clinical-presentation-in-thrombotic-thrombocytopenic-purpura-real-world-data-from-two-mexican-institutions
#16
Emmanuel Bugarin-Estrada, Andrés Gómez-De León, Yadith Karina López-García, Erik Alejandro Díaz-Chuc, José Manuel Priesca-Marín, Guillermo J Ruiz-Argüelles, José Carlos Jaime-Pérez, David Gómez-Almaguer
BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) is a hematologic disease that can be fatal if not treated early. We aimed to describe the clinical characteristics of Mexican patients with idiopathic TTP. STUDY DESIGN AND METHODS: We conducted a retrospective study, including all adult patients diagnosed with idiopathic TTP from 2011 to 2017 in two Mexican centers. We further compared our results with the published literature. RESULTS: Twenty patients were included; 70% were female, with a median age of 38...
October 15, 2018: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/30320924/reducing-allogeneic-blood-exposure-in-low-blood-volume-extracorporeal-photopheresis-patients-through-use-of-a-modified-blood-prime
#17
LETTER
Leon Su, Kristin Gray, Katie Baker, Frank Nizzi
No abstract text is available yet for this article.
October 15, 2018: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/30242893/visualization-of-bacterial-contamination-in-an-apheresis-platelet-unit
#18
Alexa J Siddon, Edward L Snyder, Christopher A Tormey
No abstract text is available yet for this article.
September 22, 2018: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/30325055/choosing-wisely-for-apheresis
#19
Laura Connelly-Smith, Yvette C Tanhehco, Vishesh Chhibber, Meghan Delaney, Quentin Eichbaum, Christine Fernandez, Sarita Joshi, Joseph Schwartz, Michael Linenberger
The Choosing Wisely campaign has stimulated clinicians to think about the appropriateness of various tests and procedures, compelling physicians to make smarter, safer and more effective choices for high quality patient care and to reduce healthcare cost. The American Society for Apheresis (ASFA) strives to advance apheresis medicine through education, evidence-based practice, research and advocacy. To complement these shared missions, ASFA created a working group, consisting of representatives from the various ASFA committees, to produce recommendations for apheresis medicine that reflect the Choosing Wisely guiding principles...
October 2018: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/30325054/therapeutic-white-blood-cell-and-platelet-depletions-using-the-spectra-optia-system-continuous-mononuclear-cell-protocol
#20
Nancy C Cates, Darlene J Oakley, Oluwatoyosi A Onwuemene
The Spectra Optia apheresis system has only recently been approved by the Food and Drug Administration (FDA) for therapeutic white blood cell (WBC) depletions and is not yet approved for platelet depletions. Prior to FDA-approval of the WBC depletion protocol, when our available COBE Spectra apheresis systems were out of service, we successfully performed WBC depletion using a modified Spectra Optia apheresis system Continuous Mononuclear Cell (CMNC) protocol. Using this modified Spectra Optia CMNC protocol, we created institutional protocols for WBC and platelet depletions...
October 2018: Journal of Clinical Apheresis
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