Complications of leukocytapheresis.
Recently leukocytapheresis (LCAP) has attracted attention as a new therapy for ulcerative colitis. We reviewed the complications associated with LCAP carried out in our department during the period from December 1992 to September 1997. There were side effects during 195 (9.9%) of the 1,978 sessions performed, involving 47 (51.1%) of the 92 patients treated. Moderate reactions, which caused considerable discomfort to the patients and required the transient interruption of the administration or some medical treatment depending on the state, occurred during 31 (1.6%) of all therapy sessions, involving 15 (16%) patients. All patients recovered soon and never fell into a life-threateningly severe state. They also did not have any symptoms afterwards. The common side effects were nausea, vomiting, fever, chills, and nasal obstruction. Reactions such as palpitations, respiratory distress, or chest oppressions were common, especially when heparin sodium (HS) was used as the anticoagulant. The type and frequency of side effects depended somewhat on the length of the therapy series or the duration of one session. Other complications such as clotting in the leukocyte removal filter and/or blood line during administration were encountered frequently. These latter problems occurred during 46% of all sessions, but most of them had little significance. Sessions in which HS was used as the anticoagulant showed more severe clotting than those in which nafamostat mesilate (NM) was used. In our series, we experienced a relatively low rate of serious complications. We require, of course, careful observation during and after each session.
Nagase
K
K
Department of Internal Medicine 4, Hyogo College of Medicine, Nishinomiya, Japan.
Sawada
K
K
Ohnishi
K
K
Egashira
A
A
Ohkusu
K
K
Shimoyama
T
T
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001550:Benzamidines; D003093:Colitis, Ulcerative / Q000628:therapy*; D003424:Crohn Disease / Q000628:therapy*; D005260:Female; D006146:Guanidines / Q000627:therapeutic use; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007937:Leukapheresis / Q000009:adverse effects*; D008297:Male
D000925:Anticoagulants; D001550:Benzamidines; D006146:Guanidines; D006493:Heparin; C032855:nafamostat