title: Comparison of plasma exchange procedures using three apheresis systems.
abstract: BACKGROUND
  A new protocol for the Amicus separator (Fresenius Kabi) enables the device to perform plasma exchange (PE). The aim of the study was to compare retrospectively the plasma removal efficiency (PRE) of the Amicus, the Optia (TerumoBCT), and the Spectra (TerumoBCT) when performing PEs.
  
  
  METHODS
  We retrospectively reviewed patients who received at least one PE with the Amicus and at least one PE with the Optia, the Spectra, or both. We collected data regarding PRE, volume of anticoagulant and calcium-magnesium (Ca-Mg) solution infused, and changes in laboratory data from patients' blood sampled immediately before starting and immediately after finishing each PE procedure: complete blood count, coagulation, acid-base equilibrium, and biochemistry variables. We also collected severe adverse events (AEs).
  
  
  RESULTS
  We performed 18, 44, and 14 PEs with the Amicus, Optia, and Spectra, respectively. We observed significant differences among the Amicus, Optia, and Spectra regarding PRE (79.8 ± 8.2, 82.9 ± 5.8, and 70.4 ± 8.2%; p < 0.001), volume of anticoagulant infused (542 ± 196, 687 ± 120, and 647 ± 111 mL; p = 0.002), volume of Ca-Mg solution infused (81 ± 28, 56 ± 16, and 63 ± 15 mL; p < 0.001), absolute change of ionic Ca (-0.04 ± 0.13, -0.05 ± 0.12, and -0.19 ± 0.16 mmol/L; p = 0.002), and absolute change of Na (1.18 ± 1.97, 1.02 ± 1.93, and 3.71 ± 1.98 mEq/L; p < 0.001). We observed no significant differences in other analytic variables and we observed no severe AEs.
  
  
  CONCLUSIONS
  The Amicus device could effectively perform PE procedures. In terms of PRE, the Amicus and Optia were similar, but both devices were superior to the Spectra. The Amicus used a lower volume of anticoagulant when compared with the Optia.
authors.affiliation: Apheresis Unit, Department of Hemotherapy and Hemostasis, CDB, IDIBAPS, Hospital Clínic, Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Cid
authors.affiliation: Apheresis Unit, Department of Hemotherapy and Hemostasis, CDB, IDIBAPS, Hospital Clínic, Barcelona, Spain.
authors.forename: Juan M
authors.initials: JM
authors.lastname: Molina
authors.affiliation: Apheresis Unit, Department of Hemotherapy and Hemostasis, CDB, IDIBAPS, Hospital Clínic, Barcelona, Spain.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Mustieles
authors.affiliation: Apheresis Unit, Department of Hemotherapy and Hemostasis, CDB, IDIBAPS, Hospital Clínic, Barcelona, Spain.
authors.forename: Montse
authors.initials: M
authors.lastname: Periáñez
authors.affiliation: Apheresis Unit, Department of Hemotherapy and Hemostasis, CDB, IDIBAPS, Hospital Clínic, Barcelona, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Lozano
mesh_terms: D000328:Adult; D000368:Aged; D001781:Blood Component Removal / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange / Q000379:methods*; D012189:Retrospective Studies