First experience with a ready-for-use rheohemapheresis system.
Rheohemapheresis is increasingly being used for the improvement of microcirculation in numerous diseases. The method is based on the constant-flow separation of plasma by a cell separator and the secondary filtration of plasma through a hollow-fiber membrane. A new CE-marked system has recently been launched for an improved continuous flow blood separator (dideco Excel Pro) that contains a connection kit between the cell separator and a secondary filter and software which includes differential filtration as a standard protocol. The new system was used in our center using ethylenevinylalcohol secondary filters (Evaflux LA4 or LA5). 99 procedures were completed in 47 patients. A median of 2.7 (1.6-4.2) 1 of plasma were processed via the secondary filter in 109 (41-218) min. The values in peripheral blood before and after the treatment were total protein 6.7 (5.8-8.9)/ 5.3 (4.4-6.7) g/dl, fibrinogen 215 (118-480)/110 (37-275) mg/dl and cholesterol 200 (134-254)/92 (69 149) mg/dl. A median platelet loss of 30% in the peripheral blood of the patients was observed partly by platelet content of the separated plasma of 30 g/l after 500 ml of treatment and 10 g/l after 2,500 ml. Major side effects in the patients were not observed. The new differential filtration system already fulfills the demands of a ready-to-use CE-marked rheohemapheresis system but improvements in the details of the treatment protocol are still required and under way.
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Deutsches Hämapherese Zentrum, Cologne, Germany. med@dhzcologne.de
Rink
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Brunner
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Borberg
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001804:Blood Transfusion, Autologous / Q000295:instrumentation / Q000379:methods; D001809:Blood Viscosity; D002469:Cell Separation / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006440:Hemofiltration / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010949:Plasma / Q000737:chemistry