The effects of double-filtration plasmapheresis on coagulation profiles and the risk of bleeding

Autor: Szu-Yu Pan, Thomas Tao-Min Huang, Yi-Chan Lin, Hui-Ting Liu, Sheng-Chieh Chou, Chih-Yuan Lee, Chien-Chia Chen, Chuan-Hsiu Fu, Chi-Chao Chao, Vin-Cent Wu
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Journal of the Formosan Medical Association, Vol 123, Iss 8, Pp 899-903 (2024)
Druh dokumentu: article
ISSN: 0929-6646
DOI: 10.1016/j.jfma.2024.02.006
Popis: Background/Purpose: Double-filtration plasmapheresis (DFPP) can be used to remove circulating pathogenic molecules. By reclaiming filtered albumin, DFPP reduces the need for albumin and plasma replacement. Large proteins, such as fibrinogen, are removed. Our institution adopts a DFPP treatment protocol consisting of active surveillance of coagulation profiles and prophylactic supplementation of blood products containing fibrinogen. This study aims to investigate the effects of consecutive DFPP treatments on serial coagulation profiles and the risk of bleeding under this protocol. Methods: Serial laboratory data and bleeding events at a single tertiary medical center were prospectively collected. Prophylactic transfusion of cryoprecipitate or fresh frozen plasma (FFP) was instituted if significant coagulopathy or a clinically evident bleeding event was observed. Results: After the first treatment session, plasma fibrinogen levels decreased from 332 ± 106 mg/dL to 96 ± 44 mg/dL in the 37 study patients. In the following sessions, plasma fibrinogen levels were maintained at around 100 mg/dL under prophylactic transfusion. No major bleeding events were recorded, but five (14%) patients experienced minor bleeding. Conclusion: DFPP treatment might be performed safely along with active monitoring of coagulation profiles and prophylactic transfusion of cryoprecipitate or FFP.
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