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Complement Activation as a Cause of Transient Hypotension During Plasmapheresis
Author(s) -
Shiga Yusei,
Fujihara Kazuo,
Onodera Hiroshi,
Nagata Tetsuya,
Itoyama Yasuto
Publication year - 1998
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1046/j.1525-1594.1998.06170.x
Subject(s) - hypovolemia , medicine , complement system , anesthesia , plasmapheresis , anaphylatoxin , immunoadsorption , chemistry , immunology , antibody
Hypotension is one of the most common adverse effect of plasmapheresis (PP) and often is attributed to hypovolemia due to extracorporeal circulation and the vasovagal reflex. Complements are activated during PP, and the activated complements are strong anaphylatoxins and potent vasodilators. Therefore, we studied the relationship between the transient hypotension and the plasma levels of activated complements during and after PP in 8 sessions of 7 patients using the Plasmafro OP‐08 as a plasma separator. Five of the patients underwent immunoadsorption PP using the IM‐TR 350 or IM‐PH 350 as the adsorption column. The other underwent double filtration PP using the Evaflux 4A as a second filter. In 4 of 8 sessions, patients experienced transient hypotension with significantly elevated plasma levels of activated complements C3a and C5a. In contrast, patients without hypotension showed no increases in C3a and C5a values during PP. In this report, we emphasize the critical role of activated complements for hypotension during PP.