Effects of extracorporeal hemapheresis therapy on blood rheology.
The blood flow property is one of the factors determining blood perfusion and oxygen supply. The viscosity of the blood is primarily related to the hematocrit, but also to the amount of fibrinogen and other macromolecules present in the blood. Patients with ischemic heart disease have shown a rapid and safe improvement in their hemorheological state when treated with heparin-induced extracorporeal low-density lipoprotein (LDL) precipitation (HELP). In this study we used two extracorporeal hemapheresis methods, plasmapheresis (PP) and immunoadsorption (IA), in 15 patients (eight patients treated with PP and seven patients with IA) with various diseases. Hemorheological variables and plasma fibrinogen were measured before and after the first and before the third treatment performed at 3 consecutive days. The aim of our study was to investigate the immediate effects of these two treatment modalities on the flow properties of blood. Immediately after the first PP and IA session statistically significant declines in plasma fibrinogen concentration, plasma viscosity, whole blood viscosity, and erythrocyte aggregation tendency were found. These changes persisted before the third treatment session. The erythrocyte fluidity and hematocrit remained unchanged. We conclude that extracorporeal hemapheresis therapy, with plasmapheresis or immunoadsorption, affects the blood rheology by decreasing the plasma viscosity and erythrocyte aggregation tendency. The decrease in plasma fibrinogen is probably the main factor underlying that, but other factors such as a decrease in immunoglobulins may also be of importance.
Fadul
J E
JE
Department of Internal Medicine, University Hospital, Uppsala, Sweden.
Linde
T
T
Sandhagen
B
B
Wikström
B
B
Danielson
B G
BG
D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D001809:Blood Viscosity; D004903:Erythrocyte Aggregation / Q000097:blood / Q000628:therapy; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006400:Hematocrit; D006801:Humans; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis; D012212:Rheology / Q000706:statistics & numerical data*
D005340:Fibrinogen