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Original Paper

Fibrinogen Reduction and Bleeding Complications in Plasma Exchange, Immunoadsorption and a Combination of the Two

Zöllner S.a · Pablik E.b · Druml W.a · Derfler K.a · Rees A.c · Biesenbach P.a

Author affiliations

aInternal Medicine III/Clinical Division of Nephrology and Dialysis, bCenter for Medical Statistics, Informatics, and Intelligent Systems, and cClinical Institute of Pathology, Medical University of Vienna, Vienna, Austria

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Blood Purif 2014;38:160-166

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: April 08, 2014
Accepted: August 18, 2014
Published online: December 04, 2014
Issue release date: December 2014

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 3

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU

Abstract

Background: Immunoadsorption (IAS) and therapeutic plasma exchange (TPE) are considered safe although fibrinogen is removed. To date no comparison of fibrinogen reduction and associated risk of bleeding in apheresis exists. Methods: Retrospective analysis of TPE, three IAS adsorbers, and combined TPE/IAS regarding fibrinogen reduction and bleeding incidence in 67 patients (1,032 treatments). Results: TPE and TPE/IAS reduced fibrinogen by 64 ± 11% and 58 ± 9%, leading to concentrations <100 mg/dl in 20 and 17% of treatments, respectively. IAS decreased fibrinogen less than TPE (26 ± 6%, p < 0.0001), resulting in fibrinogen concentrations <100 mg/dl in 1% of treatments. The processed volume correlated with reduction in TPE (r = 0.64, p < 0.01), but not in IAS. Bleeding occurred in 1.3% (IAS), 2.3% (TPE) and 3.1% (TPE/IAS) of treatments. Conclusion: Hypofibrinogenemia occurs in 20% of patients after TPE and TPE/IAS, but rarely after IAS. IAS removes fibrinogen independently of volume processed. Overall, bleeding is rare in apheresis.

© 2014 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: April 08, 2014
Accepted: August 18, 2014
Published online: December 04, 2014
Issue release date: December 2014

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 3

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU


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