1
|
Zhang Y, Dong R, Li Y, Yang X, Liu J, Ou S, Wu W. Efficacy and safety of plasma diafiltration: Review of case reports and case series. Ther Apher Dial 2023; 27:3-11. [PMID: 35437915 DOI: 10.1111/1744-9987.13859] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/17/2022] [Accepted: 04/15/2022] [Indexed: 01/05/2023]
Abstract
Plasma diafiltration (PDF), a blood purification procedure that combines dialysis with plasma filtration by a selective membrane, has been used to treat acute liver failure, sepsis, and other acute conditions. We reviewed 14 eligible case reports and case series that examined PDF in 357 patients to assess its efficacy and safety. Fourteen diseases may be indications for PDF. The primary indication in the included studies was acute liver failure without obvious inducement or cause not mentioned. Eighty-three patients reached the primary endpoint (31 deaths, 52 recoveries) and the efficacy was 62.7%. There were large changes in 16 toxins or clinical markers after PDF, including total bilirubin, IL-18, IL-6. In conclusion, PDF appears to be an effective treatment for clearance of bilirubin and other inflammatory mediators in patients with acute liver injury or a disease characterized by a systemic inflammatory state. Randomized controlled trials are needed to compare PDF with other blood purification methods, such as plasma exchange and the Molecular Adsorbent Recirculating System™.
Collapse
Affiliation(s)
- Yannan Zhang
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, Sichuan Clinical Research Center for Nephropathy, Metabolic Vascular Disease Key Laboratory, Luzhou, Sichuan, China
| | - Rui Dong
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, Sichuan Clinical Research Center for Nephropathy, Metabolic Vascular Disease Key Laboratory, Luzhou, Sichuan, China
| | - Ying Li
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, Sichuan Clinical Research Center for Nephropathy, Metabolic Vascular Disease Key Laboratory, Luzhou, Sichuan, China
| | - Xin Yang
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, Sichuan Clinical Research Center for Nephropathy, Metabolic Vascular Disease Key Laboratory, Luzhou, Sichuan, China
| | - Jiang Liu
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, Sichuan Clinical Research Center for Nephropathy, Metabolic Vascular Disease Key Laboratory, Luzhou, Sichuan, China
| | - Santao Ou
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, Sichuan Clinical Research Center for Nephropathy, Metabolic Vascular Disease Key Laboratory, Luzhou, Sichuan, China
| | - Weihua Wu
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, Sichuan Clinical Research Center for Nephropathy, Metabolic Vascular Disease Key Laboratory, Luzhou, Sichuan, China
| |
Collapse
|
2
|
Abstract
Background Heat stroke is a life-threatening injury requiring neurocritical care; however, heat stroke has not been completely examined due to several possible reasons, such as no universally accepted definition or classification, and the occurrence of heat wave victims every few years. Thus, in this review, we elucidate the definition/classification, pathophysiology, and prognostic factors related to heat stroke and also summarize the results of current studies regarding the management of heat stroke, including the use of intravascular balloon catheter system, blood purification therapy, continuous electroencephalogram monitoring, and anticoagulation therapy. Main body Two systems for the definition/classification of heat stroke are available, namely Bouchama’s definition and the Japanese Association for Acute Medicine criteria. According to the detailed analysis of risk factors, prevention strategies for heat stroke, such as air conditioner use, are important. Moreover, hematological, cardiovascular, neurological, and renal dysfunctions on admission are associated with high mortality, which thus represent the potential targets for intensive and specific therapies for patients with heat stroke. No prospective, comparable study has confirmed the efficacy of intravascular cooling devices, anticoagulation, or blood purification in heat stroke. Conclusion The effectiveness of cooling devices, drugs, and therapies in heat stroke remains inconclusive. Further large studies are required to continue to evaluate these treatment strategies.
Collapse
Affiliation(s)
- Toru Hifumi
- 1Emergency Medical Center, Kagawa University Hospital, 1750-1 Ikenobe, Miki, Kita, Kagawa 761-0793 Japan.,5Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560 Japan
| | - Yutaka Kondo
- 2Department of Emergency and Critical Care Medicine, Juntendo University, Urayasu Hospital, 2-1-1 Tomioka,Urayasu-shi, Chiba, 279-0021 Japan
| | - Keiki Shimizu
- Emergency and Critical Care Center, Tokyo Metropolitan Tama Medical Centre, 2-8-29 Musashidai, Fuchu-shi, Tokyo, 183-8524 Japan
| | - Yasufumi Miyake
- 4Department of Emergency Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-Ku, Tokyo, 173-8606 Japan
| |
Collapse
|
3
|
Kinjo N, Hamada K, Hirayama C, Shimizu M. Role of plasma exchange, leukocytapheresis, and plasma diafiltration in management of refractory macrophage activation syndrome. J Clin Apher 2017; 33:117-120. [DOI: 10.1002/jca.21570] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 06/12/2017] [Accepted: 07/05/2017] [Indexed: 02/06/2023]
Affiliation(s)
- Noriko Kinjo
- Department of Pediatrics, School of Medicine; University of the Ryukyus; Nishihara Okinawa Japan
| | - Kazuya Hamada
- Department of Pediatrics, School of Medicine; University of the Ryukyus; Nishihara Okinawa Japan
| | - Chika Hirayama
- Department of Medical Engineering Center; University of the Ryukyus Hospital; Nishihara Okinawa Japan
| | - Masaki Shimizu
- Department of Pediatrics, School of Medicine; Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University; Kanazawa Japan
| |
Collapse
|
4
|
Yamamoto H, Nakae H, Uji Y, Maeda K, Tani T, Eguchi Y. Plasma Adiponectin Levels in Acute Liver Failure Patients Treated with Plasma Filtration with Dialysis and Plasma Exchange. Ther Apher Dial 2016; 19:349-54. [PMID: 26386223 DOI: 10.1111/1744-9987.12344] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Plasma filtration with dialysis (PDF) is a blood purification therapy in which simple plasma exchange (PE) is performed using a selective membrane plasma separator while the dialysate flows outside of the hollow fibers. Improvement of hypoadiponectinemia is considered to be a useful therapeutic approach for ameliorating fatal conditions including cardio-metabolic and infectious disease. We investigated the effects of PDF in comparison to PE in terms of plasma adiponectin (APN) changes in patients with acute liver failure. Seventeen patients with liver failure were studied; PDF was performed 55 times and PE 14 times. Plasma APN levels increased significantly after PDF, while decreasing significantly after PE. PDF appears to be among the most useful blood purification therapies in acute liver failure cases in terms of increasing APN levels.
Collapse
Affiliation(s)
- Hiroshi Yamamoto
- Department of Surgery, Shiga University of Medical Science, Shiga, Japan
| | - Hajime Nakae
- Department of Emergency and Critical Care Medicine, Akita University School of Medicine, Akita, Japan
| | - Yoshitaka Uji
- Department of Gastroenterological Surgery, Shinkoga Hospital, Fukuoka, Japan
| | - Kazuhisa Maeda
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Tohru Tani
- Department of Surgery, Shiga University of Medical Science, Shiga, Japan
| | - Yutaka Eguchi
- Department of Critical and Intensive Care Medicine, Shiga University of Medical Science, Shiga, Japan
| |
Collapse
|
5
|
Inoue N, Sato A, Ikawa Y, Shimizu M, Okajima M, Taniguchi T, Yachie A. Successful treatment of exertional heat stroke using continuous plasma diafiltration. J Clin Apher 2015; 31:490-2. [PMID: 26575209 DOI: 10.1002/jca.21439] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 10/07/2015] [Accepted: 10/26/2015] [Indexed: 11/06/2022]
Abstract
We report a case of severe exertional heat stroke with multiple organ failure successfully treated with continuous plasma diafiltration (CPDF). PDF effectively removed proinflammatory cytokines, and simultaneously, supported liver function. Furthermore, CPDF therapy showed beneficial effects on multiple organ functions. These features suggest that it is a primary treatment option for exertional heat stroke with multiple organ failure. J. Clin. Apheresis 31:490-492, 2016. © 2015 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Natsumi Inoue
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Akira Sato
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Yasuhiro Ikawa
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Masaki Shimizu
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan.
| | - Masaki Okajima
- Intensive Care Unit, Kanazawa University Hospital, Kanazawa, Japan
| | - Takumi Taniguchi
- Intensive Care Unit, Kanazawa University Hospital, Kanazawa, Japan
| | - Akihiro Yachie
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| |
Collapse
|
6
|
A case of living donor liver transplant recipient treated with novel blood purification "plasma diafiltration". Int Surg 2015; 98:428-31. [PMID: 24229036 DOI: 10.9738/intsurg-d-13-00047.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Blood purification therapy is indispensable for liver transplant recipients. The case of a living donor liver transplant recipient who represented graft insufficiency and was supported by novel blood purification "plasma diafiltration" immediately after operation is presented. A 60-year-old woman was referred for living donor liver transplant because of liver cirrhosis due to hepatitis C. Elective living donor liver transplant was performed, but the graft was small for size. Thus, the signs of graft insufficiency appeared immediately after the operation, and plasma diafiltration was used as a bridge to graft regeneration. After plasma diafiltration was started, the recipient recovered promptly, and withdrawal was performed 35 hours after induction without any complications. Plasma diafiltration is a useful and safe liver support for liver transplant recipients, including immediately after liver transplantation.
Collapse
|
7
|
Shimizu M, Nakayama Y, Taniguchi T. Successful treatment of enterohemorrhagic Escherichia coli O111-induced acute encephalopathy and hemolytic-uremic syndrome with plasma diafiltration. Ther Apher Dial 2014; 18:516-8. [PMID: 24467800 DOI: 10.1111/1744-9987.12165] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Masaki Shimizu
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan.
| | | | | |
Collapse
|
8
|
Nakae H, Igarashi T, Tajimi K. Selective plasma exchange with dialysis in patients with acute liver failure. Ther Apher Dial 2013; 16:467-71. [PMID: 23046372 DOI: 10.1111/j.1744-9987.2012.01112.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Selective plasma exchange with dialysis is a blood purification therapy in which simple plasma exchange is performed using a selective membrane plasma separator while the dialysate flows out of the hollow fibers. To evaluate the effect of plasma exchange with dialysis, biochemical examination of the blood, for example, the oxidative stress regulation system and interleukin 18 levels, was performed in patients with acute liver failure. We studied four patients with acute liver failure in whom the therapy was performed (nine times in total). The degree of hepatic encephalopathy and interleukin 18 levels decreased significantly after treatment. However, total protein levels did not change significantly. The level of reactive oxygen species and total antioxidant capacity did not change significantly. Plasma exchange with dialysis may be a useful blood purification therapy in cases of acute liver failure in terms of the removal of water-soluble and albumin-bound toxins.
Collapse
Affiliation(s)
- Hajime Nakae
- Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine, Akita, Japan.
| | | | | |
Collapse
|
9
|
Nakae H, Eguchi Y, Yoshioka T, Yoshimura N, Isono M. Plasma Diafiltration Therapy in Patients With Postoperative Liver Failure. Ther Apher Dial 2011; 15:406-10. [DOI: 10.1111/j.1744-9987.2011.00969.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
10
|
Asthana A, Lee KH, Shin SJ, Perumal J, Butler L, Lee SH, Kim DP. Bromo-oxidation reaction in enzyme-entrapped alginate hollow microfibers. BIOMICROFLUIDICS 2011; 5:24117. [PMID: 21799723 PMCID: PMC3145242 DOI: 10.1063/1.3605512] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2011] [Accepted: 06/09/2011] [Indexed: 05/08/2023]
Abstract
In this article, the authors present the fabrication of an enzyme-entrapped alginate hollow fiber using a microfluidic device. Further use of enzyme-entrapped alginate hollow fibers as a biocatalytic microchemical reactor for chemical synthesis is also deliberated in this article. To ensure that there is no enzyme leaching from the fiber, fiber surfaces were coated with chitosan. To confine the mobility of reactants and products within the porous hollow fibers the entire fibers were embedded into a transparent polydimethylsiloxane (PDMS) matrix which also works as a support matrix. A vanadium-containing bromoperoxidase enzyme isolated from Corallina confusa was used as a model enzyme to demonstrate the use of these alginate hollow-fiber reactors in bromo-oxidation of phenol red to bromophenol blue at different dye flow rates. Stability of the entrapped enzyme at different temperatures and the effect of the chitosan coating on the reaction conversion were also studied. It was observed that molecules as big as 27 kDa can be retained in the matrix after coating with chitosan while molecules with molecular-weight of around 378 Da can still diffuse in and out of the matrix. The kinetic conversion rate in this microfluidic bioreactor was more than 41-fold faster when compared with the standard test-tube procedure.
Collapse
|
11
|
Nakae H, Eguchi Y, Saotome T, Yoshioka T, Yoshimura N, Kishi Y, Naka T, Furuya T. Multicenter study of plasma diafiltration in patients with acute liver failure. Ther Apher Dial 2011; 14:444-50. [PMID: 21175541 DOI: 10.1111/j.1744-9987.2010.00864.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Plasma diafiltration (PDF) is a blood purification therapy in which simple plasma exchange (PE) is performed using a selective membrane plasma separator while the dialysate flows outside the hollow fibers. A prospective, multicenter study was undertaken to evaluate the changes in bilirubin, IL-18, and cystatin C, as well as the 28-day and 90-day survival rates, with the use of PDF according to the level of severity as measured by the Model for End-Stage Liver Disease (MELD) score. Twenty-one patients with liver failure were studied: 10 patients had fulminant hepatitis and PDF therapies were performed 28 times; 11 had acute liver failure with the therapy performed 96 times. Levels of total bilirubin, IL-18, and cystatin C decreased significantly after treatment. The 28-day survival rate was 70.0% and that at 90 days was 16.7%. According to the severity of the MELD score, each of the results compared well with the use of Molecular Adsorbent Recirculating System or Prometheus therapy. In conclusion, PDF appears to be one of the most useful blood purification therapies for use in cases of acute liver failure in terms of medical economics and the removal of water-soluble and albumin-bound toxins.
Collapse
Affiliation(s)
- Hajime Nakae
- Department of Emergency and Critical Care Medicine, Akita University School of Medicine, Hondo, Akita 010-8543, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Li M, Xue J, Liu J, Kuang D, Gu Y, Lin S. Efficacy of Cytokine Removal by Plasmadiafiltration Using a Selective Plasma Separator: In Vitro Sepsis Model. Ther Apher Dial 2010; 15:98-108. [DOI: 10.1111/j.1744-9987.2010.00850.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|