How to improve clotting factors depletion in double-filtration plasmapheresis.
Level 3 - non-randomized controlled study
Non-randomized prospective comparative cohort study
PubMed 34339059 · doi:10.1002/jca.21928
What was done
A single-center prospective study evaluated 14 patients undergoing their first double-filtration plasmapheresis (DFPP) session, divided into two groups of 7: group 1 received the CascadefloEC-50W separator filter and group 2 received the reference PlasmafloOP-08W filter. Pre- and post-session measurements included immunoglobulins (IgG), lipid profiles, blood-cell counts, prothrombin time, activated partial thromboplastin time, coagulation factors, and natural anticoagulants.
What was found
Compared to group 2 (reference filter), group 1 showed significantly lower depletion of coagulation factors with molecular weight >150 kDa: fibrinogen decrease was 31% vs 70% (P = 0.004), factor V decrease was 21% vs 66% (P = 2.16e-07), factor XI decrease was 32% vs 60% (P = 6.96e-06), factor XIII-antigen decrease was 17% vs 75% (P = 0.0002), and VWF-antigen decrease was 0% vs 47% (P = 0.02). Post-session IgG reduction was 45% in group 1 and 50% in group 2 (P = 0.13), with significance maintained after adjusting for treated plasma volume and baseline factor values.
Why it matters
Selecting a specific separator filter during DFPP can preserve essential high-molecular-weight coagulation factors without compromising therapeutic IgG clearance.
Limits
The study was conducted at a single center with a very small sample size (n = 14, 7 per group). Randomization was not specified in the abstract, and clinical outcomes such as bleeding events over repeated apheresis cycles were not evaluated.
Cited by
- supports Plasmapheresis removes coagulation factors and immunoglobulins from the blood.