Regional citrate anticoagulation vs systemic heparin anticoagulation for double‐filtration plasmapheresis
| العنوان: | Regional citrate anticoagulation vs systemic heparin anticoagulation for double‐filtration plasmapheresis |
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| المؤلفون: | Swee Ping Teh, Quan Yao Ho, Yi Shern Terence Kee, Sobhana Thangaraju, Ru Yu Tan, Su Hooi Teo, Han Khim Tan, Chieh Suai Tan, Hui Lin Lina Choong, Li Choo Ng, Maslinna Abdul Rahman, Amy Ee Lin Lim, Manish Kaushik |
| المصدر: | Journal of Clinical Apheresis. 38:16-23 |
| بيانات النشر: | Wiley, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Hematology, General Medicine |
| الوصف: | Double-filtration plasmapheresis (DFPP) has been utilized for immunomodulation in kidney transplantation. Anticoagulation is important to maintain circuit patency during DFPP. We aimed to compare the efficacy and safety of regional citrate anticoagulation (RCA) with systemic heparin anticoagulation during DFPP in kidney transplant recipients.A retrospective cohort study was conducted to compare the efficacy and safety of RCA (RCA-DFPP) to systemic heparin anticoagulation (Hep-DFPP) for DFPP among kidney transplant recipients in a single tertiary center.A total of 112 sessions of DFPP were performed for 23 subjects, of which 62 sessions were RCA-DFPP and 50 sessions were Hep-DFPP. There were 13 sessions (11.6%) of premature circuit clotting, 10 sessions (16.1%) for RCA-DFPP and 3 sessions (6.0%) for Hep-DFPP (P = .10). All premature circuit clotting episodes occurred in subjects who underwent DFPP through a vascular catheter. Premature circuit clotting was associated with the use of a vascular catheter (odds ratio [OR] 14.2, 95% confidence interval [CI] 2.7-73.7; P .01) and high postfilter ionized calcium (OR 12.7, 95% CI 1.4-112.5; P .01). There was no major bleeding event. Hep-DFPP was associated with higher occurrence of hypocalcemia (OR 1.1, 95% CI 1.0-1.2; P .01) and metabolic acidosis (OR 1.4, 95% CI 1.2-2.0; P = .04), while hypomagnesemia was more common for RCA-DFPP (OR 2.9, 95% CI 1.1-7.4; P = .03).Amongst kidney transplant patients who receive DFPP therapy, RCA-DFPP may be comparable to Hep-DFPP for the maintenance of circuit patency. Functioning vascular access is vital in avoiding premature clotting of the circuit. Close monitoring of electrolyte imbalances and coagulopathy related to DFPP is recommended. |
| تدمد: | 1098-1101 0733-2459 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6b8f1bd360dbd6fff8d17ae8db6d19d8 https://doi.org/10.1002/jca.22019 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....6b8f1bd360dbd6fff8d17ae8db6d19d8 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 10981101 07332459 |
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