title: Therapeutic plasma exchange performed in tandem with hemodialysis without supplemental calcium in the apheresis circuit.
abstract: Therapeutic plasma exchange (TPE) and hemopoietic progenitor cell (HPC) collection are apheresis procedures that can safely be performed in tandem with hemodialysis. Despite the return of citrate-anticoagulated blood to the patient during HPC collection, it is not necessary to administer supplemental calcium during these procedures because the ionized calcium concentration is restored as the returning blood passes through the dialyzer. It is not known whether this applies to TPE, in which a mixture of blood and pharmaceutical albumin, an avid binder of plasma ionized calcium, is returned to the patient through the dialyzer. We report on three dialysis-dependent patients who required TPE and underwent tandem treatments without supplemental calcium in the apheresis circuit. Overall, ionized calcium fell 4-12% (P = 0.0.024) and patients reported no symptoms of hypocalcemic toxicity. Tandem hemodialysis/TPE can be performed without supplemental calcium in the apheresis circuit. J. Clin. Apheresis 32:154-157, 2017. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts.|Division of Transfusion Medicine, UMass Memorial Medical Center, Worcester, Massachusetts.|Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.|Department of Pathology, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts.|Department of Pathology, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Hiba
authors.initials: H
authors.lastname: Ibrahim
authors.affiliation: Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts.|Division of Transfusion Medicine, UMass Memorial Medical Center, Worcester, Massachusetts.|Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.|Department of Pathology, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Bailey
authors.affiliation: Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Linden
authors.affiliation: Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts.
authors.forename: Elda
authors.initials: E
authors.lastname: Hickson
authors.affiliation: Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Haynes
authors.affiliation: Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts.
authors.forename: Mindy
authors.initials: M
authors.lastname: Greene
authors.affiliation: Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts.
authors.forename: Michelle
authors.initials: M
authors.lastname: Vauthrin
authors.affiliation: Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts.|Division of Transfusion Medicine, UMass Memorial Medical Center, Worcester, Massachusetts.|Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.|Department of Pathology, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Robert
authors.initials: R
authors.lastname: Weinstein
mesh_terms: D001781:Blood Component Removal / Q000379:methods*; D002118:Calcium / Q000008:administration & dosage / Q000097:blood*; D006412:Hematopoietic Stem Cells / Q000166:cytology; D006801:Humans; D006996:Hypocalcemia; D007937:Leukapheresis / Q000379:methods; D008875:Middle Aged; D010951:Plasma Exchange / Q000379:methods*; D006435:Renal Dialysis; D000075462:Serum Albumin, Human / Q000378:metabolism
chemical_list: D002118:Calcium; D000075462:Serum Albumin, Human
keywords: apheresis; calcium; humoral rejection; renal failure; transplant