Plasma Exchange Using an Albumin Solution as Replacement Fluid

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  • Miyamoto,Satoko
    Department of Clinical Engineering, Tokyo Medical and Dental University School of Medicine
  • Ohkubo,Atsushi
    Department of Clinical Engineering, Tokyo Medical and Dental University School of Medicine
  • Nakamura,Ayako
    Department of Clinical Engineering, Tokyo Medical and Dental University School of Medicine
  • Kurashima,Naoki
    Department of Clinical Engineering, Tokyo Medical and Dental University School of Medicine

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Other Title
  • アルブミン溶液を用いた単純血漿交換療法

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Description

Plasma exchange (PE) using an albumin solution as replacement fluid is applied for the treatment of a variety of disorders, such as demyelinating neuropathies. Though it is important to remove IgG to treat these diseases, coagulation factors such as fibrinogen (Fib) and anti-thrombin III (ATIII) are also potentially removed by this modality. Therefore we retrospectively investigated the IgG removal efficacy and the dynamics of coagulation factors during treatment by PE with albumin solution replacement. Blood samples were obtained before and after the procedure to compare the removal rates of IgG and coagulation factors. The removal rate of IgG was 61.8%, 64.9%, and 68.6% in 0.8, 0.9, and 1.0 plasma volume (PV) exchange, respectively. The removal rates of Fib and ATIII correlated with the IgG removal rate, but the decrease in platelet number did not. Serum concentration of Fib and ATIII recovered to pretreatment values three days and two days after the procedures, respectively. In conclusion, frequent treatment by PE using an albumin solution as replacement fluid requires close monitoring of coagulation factors such as Fib and ATIII. Adjustment of the anticoagulation regimen might also be necessary according to the decrease of these factors.

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