Divide et Vinces, Therapeutic Apheresis in Nephrological Clinical Practice.

IF 2.2 3区 医学 Q3 HEMATOLOGY Blood Purification Pub Date : 2024-01-01 Epub Date: 2023-12-19 DOI:10.1159/000534455
Juliana Mantilla, Danna Peña, Alejandra Molano-Triviño, Eduardo Zúñiga, Juan Camilo Castellanos-De La Hoz
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引用次数: 0

摘要

治疗性血浆置换术(TPE)或血浆置换术已被用于各种危及生命的疾病的主要治疗或与其他疗法联合使用。20 世纪 60 年代,它首次成功用于治疗瓦尔登斯特伦氏病和骨髓瘤等疾病。从那时起,使用分离膜的 TPE 技术开始问世。无细胞疗法使用膜筛选或离心方法从血液中分离血浆成分。TPE 的目的是去除涉及疾病病理生理学的物质。它可选择性地去除高分子量分子、半衰期较长的物质以及与疾病发病机制有关的物质。TPE 可用膜或离心法进行,并用白蛋白或新鲜冰冻血浆替代提取的血浆量。TPE 要求具备肾内科方面的特殊能力,可由肾内科医师开具处方并进行监控,由透析护理人员执行。TPE 可与吸附疗法相结合,以增强其效果,这种方法被称为血浆滤过吸附疗法。另一种方法是双重血浆滤过,根据分子大小选择性地清除物质。TPE 还可与脂蛋白清除策略相结合,用于控制家族性高胆固醇血症。TPE 是一种经济实惠的体外疗法,可使患有危及生命疾病的患者受益。它需要肾病专家和其他专家的合作,我们的研究结果表明,在普通住院或门诊环境下,TPE 无需抗凝即可成功。
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Divide et Vinces, Therapeutic Apheresis in Nephrological Clinical Practice.

Therapeutic plasma exchange (TPE) or plasmapheresis has been used in various life-threatening diseases as a primary treatment or in combination with other therapies. It was first successfully employed in the 1960s for diseases like Waldenström's disease and myeloma. Since then, TPE techniques using apheresis membranes have been introduced. Apheresis therapies separate plasma components from blood using membrane screening or centrifugation methods. TPE aims to remove substances involved in the pathophysiology of diseases. It selectively removes high-molecular-weight molecules, substances with prolonged half-life, and those associated with disease pathogenesis. TPE can be performed using membranes or centrifugation, with replacement of extracted plasma volume using albumin or fresh frozen plasma. TPE requires specific competencies in nephrology and can be prescribed and monitored by nephrologists and performed by dialysis nursing staff. TPE can be combined with adsorption-based therapies to enhance its effect, and this approach is called plasma filtration adsorption. Another variation is double plasma filtration, which selectively removes substances based on molecular size. TPE can also be combined with lipoprotein removal strategies for managing familial hypercholesterolemia. TPE is an affordable extracorporeal therapy that benefits patients with life-threatening diseases. It requires collaboration between nephrologists and other specialists, and our results demonstrate successful TPE without anticoagulation in general hospitalization or outpatient settings.

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来源期刊
Blood Purification
Blood Purification 医学-泌尿学与肾脏学
CiteScore
5.80
自引率
3.30%
发文量
69
审稿时长
6-12 weeks
期刊介绍: Practical information on hemodialysis, hemofiltration, peritoneal dialysis and apheresis is featured in this journal. Recognizing the critical importance of equipment and procedures, particular emphasis has been placed on reports, drawn from a wide range of fields, describing technical advances and improvements in methodology. Papers reflect the search for cost-effective solutions which increase not only patient survival but also patient comfort and disease improvement through prevention or correction of undesirable effects. Advances in vascular access and blood anticoagulation, problems associated with exposure of blood to foreign surfaces and acute-care nephrology, including continuous therapies, also receive attention. Nephrologists, internists, intensivists and hospital staff involved in dialysis, apheresis and immunoadsorption for acute and chronic solid organ failure will find this journal useful and informative. ''Blood Purification'' also serves as a platform for multidisciplinary experiences involving nephrologists, cardiologists and critical care physicians in order to expand the level of interaction between different disciplines and specialities.
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