Basic Study of Fibrinogen Elimination by Low-Density Lipoprotein (LDL) Apheresis : Comparison of the Double-Filtration Plasmapheresis (DF) Thermo and Dextran Sulfate (DS) Adsorption Methods

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  • Eguchi,Kei
    Department of Clinical Engineering Tokyo Women's Medical University
  • Minematsu,Yusuke
    Department of Clinical Engineering Tokyo Women's Medical University
  • Kaneko,Iwakazu
    Department of Clinical Engineering Tokyo Women's Medical University
  • Moriyama,Takahito
    Department of Medicine IV Tokyo Women's Medical University
  • Kawashima,Akira
    Division of Blood Purification, Kidney Center, Tokyo Women's Medical University
  • Mineshima,Michio
    Department of Clinical Engineering Tokyo Women's Medical University
  • Akiba,Takashi
    Division of Blood Purification, Kidney Center, Tokyo Women's Medical University

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  • LDLアフェレシスにおけるフィブリノーゲン除去に関する基礎的研究 : DFPP(DF)サーモ法とデキストラン硫酸(DS)吸着法の比較(<特集>アフェレシスにおけるセイフティーマネジメント)

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Since fibrinogen is a factor that is thought to cause or be related to arteriosclerosis obliterans (ASO), we compared two LDL apheresis methods (DF Thermo and DS adsorption) in terms of their fibrinogen elimination profile. A crossover study on the same plasma volume revealed that the mean elimination rate by DF Thermo and DS adsorption was 49% and 39%, respectively, suggesting the superiority of the DF Thermo method. The fibrinogen elimination profiles for plasma samples collected from each point of the extracorporeal circuit were also determined. Fibrinogen was efficiently separated by the plasma fractionator membrane of the DF Thermo method. The reduction rate for plasma fibrinogen in the DS adsorption column was more prominent during the initial stage of perfusion but gradually diminished with time as adsorption capacity of the column was saturated. High concentrations of coagulation and fibrinolysis activation products and some degradation products were detected in the waste fluid after adsorption. These results contradict previous reports and suggest the possibility of adsorbing fibrinogen with the DS adsorbent.

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