Comparison of plasma exchange procedures using three apheresis systems

Background A new protocol for the A micus separator ( F resenius K abi) enables the device to perform plasma exchange ( PE ). The aim of the study was to compare retrospectively the plasma removal efficiency ( PRE ) of the A micus, the O ptia ( T erumo BCT ), and the S pectra ( T erumo BCT ) when performing PE s. Study Design and Methods We retrospectively reviewed patients who received at least one PE with the A micus and at least one PE with the O ptia, the S pectra, or both. We collected data regarding PRE , volume of anticoagulant and calcium‐magnesium ( C a‐ M g) solution infused, and changes in laboratory data from patients' blood sampled immediately before starting and immediately after finishing each PE procedure: complete blood count, coagulation, acid‐base equilibrium, and biochemistry variables. We also collected severe adverse events ( AEs ). Results We performed 18, 44, and 14 PE s with the A micus, O ptia, and S pectra, respectively. We observed significant differences among the A micus, O ptia, and S pectra regarding PRE (79.8 ± 8.2, 82.9 ± 5.8, and 70.4 ± 8.2%; p < 0.001), volume of anticoagulant infused (542 ± 196, 687 ± 120, and 647 ± 111 mL; p = 0.002), volume of C a‐ M g solution infused (81 ± 28, 56 ± 16, and 63 ± 15 mL; p < 0.001), absolute change of ionic C a (−0.04 ± 0.13, −0.05 ± 0.12, and −0.19 ± 0.16 mmol/L; p = 0.002), and absolute change of N a (1.18 ± 1.97, 1.02 ± 1.93, and 3.71 ± 1.98  mEq / L ; p < 0.001). We observed no significant differences in other analytic variables and we observed no severe AE s. Conclusion The A micus device could effectively perform PE procedures. In terms of PRE , the A micus and O ptia were similar, but both devices were superior to the S pectra. The A micus used a lower volume of anticoagulant when compared with the O ptia.