title: The effect of immunoadsorption with the Immusorba TR-350 column on coagulation compared to plasma exchange.
abstract: OBJECTIVE
  Plasma exchange (PE) and immunoadsorption with the Immusorba TR-350 column (IA) are used to remove autoantibodies from plasma in acute neurological autoimmune disorders. The impact of IA on coagulation and on low molecular weight heparin (LMWH) levels in comparison with PE was investigated.
  
  
  METHODS
  In five patients with neurological autoimmune disorders, coagulation parameters (global tests, coagulation factors) were measured before and after PE or IA (Part A). In five other patients under anticoagulation with LMWH, anti-Xa activity and global tests were measured before and after the treatments (Part B).
  
  
  RESULTS
  After PE, coagulation factors were significantly reduced by 50-70%. After IA, a distinct reduction was observed for fibrinogen, but not for antithrombin and most of the other coagulation factors. Anti-Xa activity was reduced after PE (from 0.57 ± 0·10 to 0.13 ± 0.05 IU/ml) and almost unchanged after IA.
  
  
  CONCLUSIONS
  It is advisable to discontinue or to reduce LMWH doses and to monitor coagulation parameters and anti-Xa activity after PE or IA to decide about further LMWH dosing.
authors.affiliation: Institute of Transfusion Medicine and Haemotherapy, University of Wuerzburg, Wuerzburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Koessler
authors.forename: A
authors.initials: A
authors.lastname: Kobsar
authors.forename: S
authors.initials: S
authors.lastname: Kuhn
authors.forename: A
authors.initials: A
authors.lastname: Koessler
authors.forename: P
authors.initials: P
authors.lastname: Yilmaz
authors.forename: E
authors.initials: E
authors.lastname: Weinig
authors.forename: E
authors.initials: E
authors.lastname: Putz
authors.forename: M
authors.initials: M
authors.lastname: Boeck
authors.forename: E
authors.initials: E
authors.lastname: Klinker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001777:Blood Coagulation; D001779:Blood Coagulation Factors / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange / Q000379:methods*; D010956:Plasmapheresis / Q000379:methods*
chemical_list: D001779:Blood Coagulation Factors
keywords: Immusorba TR-350 column; anti-Xa activity; immunoadsorption; plasma exchange