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Fibrinogen Reduction During Selective Plasma Exchange due to Membrane Fouling
Author(s) -
Ohkubo Atsushi,
Okado Tomokazu,
Miyamoto Satoko,
Hashimoto Yurie,
Komori Shigeto,
Yamamoto Motoki,
Maeda Takuma,
Itagaki Ayako,
Yamamoto Hiroko,
Seshima Hiroshi,
Kurashima Naoki,
Iimori Soichiro,
Naito Shotaro,
Sohara Eisei,
Uchida Shinichi,
Rai Tatemitsu
Publication year - 2017
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12564
Subject(s) - fibrinogen , medicine , chromatography , plasma , volume (thermodynamics) , membrane , chemistry , biochemistry , physics , quantum mechanics
Fibrinogen is substantially reduced by most plasmapheresis modalities but retained in selective plasma exchange using Evacure EC‐4A10 (EC‐4A). Although EC‐4A's fibrinogen sieving coefficient is 0, a session of selective plasma exchange reduced fibrinogen by approximately 19%. Here, we investigated sieving coefficient in five patients. When the mean processed plasma volume was 1.15 × plasma volume, the mean reduction of fibrinogen during selective plasma exchange was approximately 15%. Fibrinogen sieving coefficient was 0 when the processed plasma volume was 1.0 L, increasing to 0.07 when the processed plasma volume was 3.0 L, with a mean of 0.03 during selective plasma exchange. When fibrinogen sieving coefficient was 0, selective plasma exchange reduced fibrinogen by approximately 10%. Scanning electron microscopy images revealed internal fouling of EC‐4A's hollow fiber membrane by substances such as fibrinogen fibrils. Thus, fibrinogen reduction by selective plasma exchange may be predominantly caused by membrane fouling rather than filtration.