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Witt V, Stegmayr B. The WAA-registry. Transfus Apher Sci 2024; 63:103889. [PMID: 38388335 DOI: 10.1016/j.transci.2024.103889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Affiliation(s)
- Volker Witt
- St-Anna University Hospital, Vienna, Austria
| | - Bernd Stegmayr
- Department of Public Health and Clinical Medicine Umea University, 90187 Umea, Sweden
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Vrielink H, Le Poole K, Stegmayr B, Kielstein J, Berlin G, Ilhan O, Seval GC, Prophet H, Aandahl A, Deeren D, Bojanic I, Blaha M, Lanska M, Gasova Z, Bhuiyan-Ludvikova Z, Blahutova S, Hrdlickova R, Audzijoniene J, Griskevicius A, Glatt T, Strineholm V, Ott M, Nilsson T, Newman E, Derfler K, Witt V, Toss F. The world apheresis association registry, 2023 update. Transfus Apher Sci 2023; 62:103831. [PMID: 37827962 DOI: 10.1016/j.transci.2023.103831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
The WAA apheresis registry contains data on more than 140,000 apheresis procedures conducted in 12 different countries. The aim is to give an update of indications, type and number of procedures and adverse events (AEs). MATERIAL AND METHODS: The WAA-registry is used for registration of apheresis procedures and is free of charge. The responsible person for a center can apply at the site www.waa-registry.org RESULTS: Data includes reported AEs from 2012 and various procedures and diagnoses during the years 2018-2022; the latter in total from 27 centers registered a total of 9500 patients (41% women) that began therapeutic apheresis (TA) during the period. A total of 58,355 apheresis procedures were performed. The mean age was 50 years (range 0-94). The most common apheresis procedure was stem cell collection for which multiple myeloma was the most frequent diagnosis (51%). Donor cell collection was done in 14% and plasma exchange (PEX) in 28% of patients; In relation to all performed procedures PEX, using a centrifuge (35%) and LDL-apheresis (20%) were the most common. The main indication for PEX was TTP (17%). Peripheral veins were used in 56% as the vascular access. The preferred anticoagulant was ACD. AEs occurred in 2.7% of all procedures and were mostly mild (1%) and moderate 1.5% (needed supportive medication) and, only rarely, severe (0.15%). CONCLUSION: The data showed a wide range of indications and variability in apheresis procedures with low AE frequency.
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Affiliation(s)
- Hans Vrielink
- Unit of Transfusion medicine of Sanquin Blood Supply, Sanquin Blood Supply Foundation in Amsterdam, the Netherlands
| | - Kaatje Le Poole
- Unit of Transfusion medicine of Sanquin Blood Supply, Sanquin Blood Supply Foundation in Amsterdam, the Netherlands
| | - Bernd Stegmayr
- Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
| | - Jan Kielstein
- Academic Teaching Hospital Braunschweig, Medical Clinic V - Nephrology, Rheumatology, Blood Purification, Germany
| | - Gösta Berlin
- Department of Clinical Immunology and Transfusion Medicine, and Department of Biochemical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Osman Ilhan
- Department Haematology, University Hospital, Ankara, Turkey
| | | | | | - Astrid Aandahl
- Dep of Immunology and Transfusion Medicine, Akershus University Hospital, Lorenskog, Norway
| | | | - Ines Bojanic
- Clinical Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Croatia
| | - Milan Blaha
- IV. Internal Hematological Klinik, Fakultni Nemocnice, Hradec Králové, Czech Republic
| | - Miriam Lanska
- IV. Internal Hematological Klinik, Fakultni Nemocnice, Hradec Králové, Czech Republic
| | - Zdenka Gasova
- Apheresis Department, Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | | | - Sarka Blahutova
- Blood Centre, University Hospital Ostrava, Ostrava, Czech Republic
| | | | - Judita Audzijoniene
- Therapeutic apheresis unit, Vilnius university hospital Santariskiu clinics, Vilnius, Lithuania
| | - Antanas Griskevicius
- Therapeutic apheresis unit, Vilnius university hospital Santariskiu clinics, Vilnius, Lithuania
| | - Tanya Glatt
- South African National Blood Service, Johannesburg, South Africa
| | | | - Michael Ott
- Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Thomas Nilsson
- Department of Nephrology, University Hospital, Uppsala, Sweden
| | - Elizabeth Newman
- Bone Marrow Transplant & Apheresis, Apheresis & Cell Therapies Unit, Concord Repatriation General Hospital, Concord, NSW, Australia
| | - Kurt Derfler
- The Institute for the Diagnosis and Therapy of Atherosclerosis and Fat Metabolism Disorders, Athos, Vienna, Austria
| | - Volker Witt
- St. Anna Kinderspital, University Hospital, Vienna, Austria
| | - Fredrik Toss
- Department of Clinical Microbiology, Division of Clinical Immunology, Umeå University, Umeå, Sweden
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Baglan E, Ozdel S, Uysal Yazıcı M, Azapağası E, Çelik H, Yüksel D, Uçan B, Karakaya D, Bulbul M. A novel therapeutic approach using the Zipper method to treat chorea in a pediatric-onset systemic lupus erythematosus patient. Lupus 2021; 30:502-509. [PMID: 33413004 DOI: 10.1177/0961203320984013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Pediatric-onset systemic lupus erythematosus is among the prototypic systemic autoimmune diseases seen in children. Although the neuropsychiatric involvement rate varies during the course of the disease, it is an important cause of morbidity and mortality. The clinical picture of neuropsychiatric SLE (NPSLE) is highly variable, and neurological features can precede systemic findings, leading to some diagnostic difficulties. NPSLE requires early and aggressive immunosuppressive therapy. Some patients can be resistant to immunosuppressive therapy. Chorea is a rare manifestation that occurs in 1.2%-2% of SLE patients and can result from an immunologically mediated mechanism, antiphospholipid autoantibodies or ischemia. Herein we present the first case of pediatric-onset SLE diagnosed with central nervous system involvement and treated with Zipper method. The Zipper method is a new immunomodulation treatment. The clinical findings of the patient, which were resistant to corticosteroids and cyclophosphamide, resolved by this novel treatment.
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Affiliation(s)
- Esra Baglan
- Department of Pediatric Rheumatology and Nephrology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Semanur Ozdel
- Department of Pediatric Rheumatology and Nephrology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Mutlu Uysal Yazıcı
- Pediatric Intensive Care Unit, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Ebru Azapağası
- Pediatric Intensive Care Unit, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Halil Çelik
- Department of Pediatric Neurology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Deniz Yüksel
- Department of Pediatric Neurology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Berna Uçan
- Pediatric Radiology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Deniz Karakaya
- Department of Pediatric Rheumatology and Nephrology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Mehmet Bulbul
- Department of Pediatric Rheumatology and Nephrology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
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Stegmayr B, Newman E, Witt V, Derfler K, Leitner G, Eloot S, Dhondt A, Deeren D, Ptak J, Blaha M, Lanska M, Gasova Z, Bhuiyan-Ludvikova Z, Hrdlickova R, Ramlow W, Prophet H, Kielstein JT, Liumbruno G, Mori E, Griskevicius A, Audzijoniene J, Vrielink H, Rombout-Sestrienkova E, Aandahl A, Sikole A, Tomaz J, Lalic K, Bojanic I, Strineholm V, Brink B, Berlin G, Dykes J, Nilsson T, Eich T, Hadimeri H, Welander G, Ortega Sanchez S, Ilhan O, Poole C. Using the World Apheresis Association Registry Helps to Improve the Treatment Quality of Therapeutic Apheresis. Transfus Med Hemother 2021; 48:234-239. [PMID: 34539317 DOI: 10.1159/000513123] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 04/07/2020] [Indexed: 01/20/2023] Open
Abstract
Therapeutic apheresis (TA) is prescribed to patients that suffer from a severe progressive disease that is not sufficiently treated by conventional medications. A way to gain more knowledge about this treatment is usually by the local analysis of data. However, the use of large quality assessment registries enables analyses of even rare findings. Here, we report some of the recent data from the World Apheresis Association (WAA) registry. Data from >104,000 procedures were documented, and TA was performed on >15,000 patients. The main indication for TA was the collection of autologous stem cells (45% of patients) as part of therapy for therapy. Collection of stem cells from donors for allogeneic transplantation was performed in 11% of patients. Patients with indications such as neurological diseases underwent plasma exchange (28%). Extracorporeal photochemotherapy, lipid apheresis, and antibody removal were other indications. Side effects recorded in the registry have decreased significantly over the years, with approximately only 10/10,000 procedures being interrupted for medical reasons. Conclusion Collection of data from TA procedures within a multinational and multicenter concept facilitates the improvement of treatment by enabling the analysis of and feedback on indications, procedures, effects, and side effects.
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Affiliation(s)
- Bernd Stegmayr
- Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Elizabeth Newman
- Bone Marrow Transplant and Apheresis, Concord, New South Wales, Australia
| | - Volker Witt
- St. Anna, Pediatric Department, Vienna, Austria
| | | | - Gerda Leitner
- Apheresis Unit, Haematological, AKH, Vienna, Austria
| | - Sunny Eloot
- Department of Nephrology, University Hospital, Ghent, Belgium
| | | | - Dries Deeren
- Department of Hematology, AZ Delta, Roeselare, Belgium
| | - Jan Ptak
- Transfusion Medicine, Frydek-Mistek, Czechia
| | - Milan Blaha
- Hemapheretic Center of the 3rd Department of Medicine, Medical Faculty and University Hospital, Hradec Kralove, Czechia
| | - Mirka Lanska
- Hemapheretic Center of the 3rd Department of Medicine, Medical Faculty and University Hospital, Hradec Kralove, Czechia
| | - Zdenka Gasova
- Institute of Hematology and Blood Transfusion, Prague, Czechia
| | | | | | | | | | - Jan T Kielstein
- Nephrology, Rheumatology, Blood Purification, Academic Teaching Hospital, Braunschweig, Germany
| | | | | | | | | | | | | | - Astrid Aandahl
- Center for Immunology and Transfusion, Akers University Hospital, Loerenskog, Norway
| | - Aleksandar Sikole
- Department of Nephrology, University Hospital, Skopje, North Macedonia
| | - Jorge Tomaz
- Apheresis Unit, Coimbra University Hospital, Coimbra, Portugal
| | - Katarina Lalic
- Institute for Endocrinology, University Hospital, Belgrade, Serbia
| | - Ines Bojanic
- Transfusion Medicine and Transplantation Biology, University, Zagreb, Croatia
| | | | - Bo Brink
- Department of Nephrology, University Hospital, Huddinge, Sweden
| | - Gösta Berlin
- Clinical Immunology and Transfusion Medicine, Linköping University, Linköping, Sweden
| | | | - Thomas Nilsson
- Department of Nephrology, University Hospital, Uppsala, Sweden
| | - Torsten Eich
- Blood Center, University, Uppsala, Sweden, Uppsala, Sweden
| | - Henrik Hadimeri
- Department of Nephrology, Skaraborg Hospital, Skövde, Sweden
| | | | | | - Osman Ilhan
- Department Haematology, University Hospital, Ankara, Turkey
| | - Colwyn Poole
- South African National Blood Service, Johannesburg, South Africa
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Córdoba JP, Larrarte C, Estrada C, Fernández-Ávila DG. Therapeutic plasma exchange in rheumatic diseases: a university hospital experience. REVISTA BRASILEIRA DE REUMATOLOGIA 2017; 57:397-402. [PMID: 29037311 DOI: 10.1016/j.rbre.2017.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 11/08/2016] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Each day, evidence accumulates related to the use of therapeutic plasma exchange (TPE) in patients with rheumatic diseases. San Ignacio University Hospital has recorded all of the TPE sessions performed by the institution's apheresis group. OBJECTIVE To describe the TPE experience of patients with rheumatologic diseases in a hospital setting. METHODS Descriptive, observational, retrospective analysis. This study included analyses of the TPE sessions that were performed in patients with rheumatic diseases from November 2009 to November 2013. RESULTS The apheresis group performed 136 sessions in 27 patients. The mean patient age was 43 years (SD 18.5), and 59.3% of the patients were female. Regarding the diagnosis, the most frequents ones where: ANCA-associated vasculitis followed by systemic lupus erythematosus and catastrophic antiphospholipid syndrome. The average number of sessions per patient was 5 (SD 1.8), and the average plasma exchange per patient was 1.3 plasma volume replacement units. The most used replacement solution was frozen fresh plasma (FFP; 63.2% of the sessions). Of all the sessions, 4.4% presented complications, and the majority of the complications were related to vascular access. Fifteen patients required renal replacement therapy (RRT) secondary to the same cause that created the need for TPE, 3 patients required RRT due to causes other than the TPE diagnostic intervention and 1 patient had undergone chronic dialysis. CONCLUSIONS TPE is a therapeutic alternative that is needed for the management of patients with rheumatic diseases with renal involvement and those who are refractory to conventional management. Our clinical results were in agreement with the global literature.
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Affiliation(s)
- Juan Pablo Córdoba
- Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogota, Colombia
| | - Carolina Larrarte
- Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogota, Colombia
| | - Cristina Estrada
- Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogota, Colombia
| | - Daniel G Fernández-Ávila
- Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogota, Colombia; Pontificia Universidad Javeriana, Facultad de Medicina, Bogota, Colombia.
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Córdoba JP, Larrarte C, Estrada C, Fernández-Ávila DG. Troca plasmática terapêutica em doenças reumáticas: a experiência de um hospital universitário. REVISTA BRASILEIRA DE REUMATOLOGIA 2017. [DOI: 10.1016/j.rbr.2016.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Schettler VJJ, Neumann CL, Peter C, Zimmermann T, Julius U, Roeseler E, Heigl F, Grützmacher P, Blume H. Current insights into the German Lipoprotein Apheresis Registry (GLAR) - Almost 5 years on. ATHEROSCLEROSIS SUPP 2017; 30:50-55. [PMID: 29096861 DOI: 10.1016/j.atherosclerosissup.2017.05.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND In recent years the Federal Joint Committee (G-BA), a paramount decision-making body of the German health care system required a reassessment of the approval of chronic lipoprotein apheresis therapy for regular reimbursement. Since 2005 an interdisciplinary German apheresis working group has been established by members of both German Societies of Nephrology. In 2009 the working group completed the indication for lipoprotein apheresis with respect to current cardiovascular guidelines and current scientific knowledge for the registry. In 2011 the German Lipoprotein Apheresis Registry (GLAR) was launched and data acquired over nearly 5 years can now be reported. METHODS AND RESULTS All data were collected and analyzed during the time period 2012-2015. Over this time interval, 68 German apheresis centers collected retrospective and prospective observational data of 1.283 patients undergoing lipoprotein apheresis (LA) treatment of high LDL-cholesterol (LDL-C) levels and/or high lipoprotein(a) (Lp(a)) levels suffering from progressive cardiovascular disease (CVD). A total of 15,167 documented LA treatments were investigated. All patients treated by LA exhibited a median LDL-C reduction rate of 68.6%, and a median Lp(a) reduction rate of 70.4%. Analogue to the Pro(a)LiFe pattern, patient data were analyzed and compared with respect to the incidence rate of coronary events (MACE) 1 and 2 years before the start of LA treatment (y-2 and y-1) and prospectively one year on LA treatment (y+1). During the first year of LA treatment a MACE reduction of 97% was be observed. In the years considered, LA treatment side effects occurred at a low rate (ca. 5%) and mainly comprised puncture problems. CONCLUSIONS For the first time data generated by the GLAR shows that LA lowers the incidence rate of cardiovascular events in patients with high LDL-C and/or high Lp(a) levels, progressive CVD and maximally tolerated lipid lowering medication. In addition LA treatments were found to be safe, exhibiting a low rate of side effects.
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Affiliation(s)
| | - C L Neumann
- BRAVE e Benefit for Research on Arterial Hypertension, Dyslipidemia and Vascular Risk and Education e.V., Göttingen, Germany
| | - C Peter
- BioArtProducts GmbH (B.A.P.), Rostock, Germany; Fraunhofer Institute for Cell Therapy and Immunology IZI, Rostock Group (EXIM), Germany
| | | | - U Julius
- Department of Medicine III, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany
| | - E Roeseler
- Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany
| | - F Heigl
- Medical Care Centre Kempten-Allgäu, Kempten, Germany
| | - P Grützmacher
- Department of Medicine II for Nephrology, Hypertension and Vascular Risks, AGAPLESION Markus Hospital, Frankfurt, Germany
| | - H Blume
- Scientific Institute for Nephrology (WiNe), Düsseldorf, Germany
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Abstract
BACKGROUND Since 2005 an interdisciplinary German apheresis working group has been established by members of both German Societies of Nephrology and of Lipidologists and completed the data set for the registry according to the current guidelines and the German indication guideline for apheresis in 2009. In 2011 the German Lipoprotein Apheresis Registry (GLAR) was launched and data are available over nearly 5 years now. METHODS AND RESULTS During the time period 2012-2016, 71 German apheresis centers collected retrospective and prospective observational data of 1435 patients undergoing lipoprotein apheresis (LA) treatment of high LDL-C levels and/or high Lp (a) levels suffering from cardiovascular disease (CVD) or progressive CVD. A total of 15,527 completely documented LA treatments were entered into the database. All patients treated by LA showed a median LDL-C reduction rate of 67.5%, and a median Lp (a) reduction rate of 71.1%. Analog to the Pro(a)LiFe pattern, patient data were analyzed to the incidence rate of coronary events (MACE) 1 and 2 years before the beginning of LA treatment (y-2 and y‑1) and prospectively two years on LA treatment (y + 1 and y + 2). During two years of LA treatment a MACE reduction of 78% was observed. In the years considered, side effects of LA treatment were low (5.9%) and mainly comprised puncture problems. CONCLUSIONS The data generated by the GLAR shows that LA lowers the incidence rate of cardiovascular events in patients with high LDL-C and/or high Lp (a) levels, progressive CVD, and maximally tolerated lipid lowering medication. In addition, LA treatments were found to be safe with a low rate of side effects.
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Distribution of indications and procedures within the framework of centers participating in the WAA apheresis registry. Transfus Apher Sci 2017; 56:71-74. [DOI: 10.1016/j.transci.2016.12.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Guptill JT, Oakley D, Kuchibhatla M, Guidon AC, Hobson-Webb LD, Massey JM, Sanders DB, Juel VC. A Retrospective study of complications of therapeutic plasma exchange in myasthenia. Muscle Nerve 2012; 47:170-6. [DOI: 10.1002/mus.23508] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2012] [Indexed: 11/12/2022]
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Bláha M, Pták J, Čáp J, Ceeová V, Mašín V, Filip S, Blažek M. WAA apheresis registry in the Czech Republic: Two centers experience. Transfus Apher Sci 2009; 41:27-31. [DOI: 10.1016/j.transci.2009.05.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
OBJECTIVES Seventy-five centers from many countries have applied for a login code to the WAA apheresis registry. Fifteen centers from 7 countries have been actively entering data at the internet site from 2003 until 2007. We report on data from the registry so far. METHODS This is a web-based registry. A link is available from the WAA homepage (www.worldapheresis.org). So far data from 2013 patients (12,448 procedures) have been included. A median of 6 treatments have been performed (range 1-140). Mean age 51 years (range 1-94 years; 45% women). Seven percent of the patients were < or = 21 years and 4% were < or = 16 years. RESULTS The purpose of the apheresis procedure was therapeutic in 67% and retrieval of blood components in 33%. Main indications: neurological and hematological diseases, lipid apheresis and stemcell collection (autologous, and some allogeneic). Blood access: peripheral vessels (71%), central dialysis catheter through jugular (6.5%) or subclavian veins (6.7%), femoral vein (8%) and AV fistula (4%). ACD was used for anticoagulation in 73% of the procedures. Albumin was mainly used as replacement fluid. Adverse events (AE) were registered in 5.7% of the procedures. AE was graded as mild (2.5%), moderate (2.7%) or severe (0.5%). No death occurred due to treatment. The procedures were interrupted in 2.6%. Most frequent AEs were blood access problems (29%), tingling around the mouth (20%), hypotension (18%), and urticaria (9%). There were significant differences between the centers regarding mild and moderate AEs. Data indicate that centers using continuous infusion of calcium had fewer AEs. CONCLUSION There was a limited number of severe AEs. Centers use various standard procedures for apheresis. By learning from the experience of others the treatment quality will improve further. In the near future, an update of the registry will enable more extensive evaluation of the data.
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Establishment of a national on-line registry for apheresis in Korea. Transfus Apher Sci 2008; 38:93-100. [DOI: 10.1016/j.transci.2008.01.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2007] [Revised: 10/10/2007] [Accepted: 01/11/2008] [Indexed: 11/17/2022]
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Arslan O, Arat M. Apheresis information management system (AMIS). Transfus Apher Sci 2007; 36:281-3. [PMID: 17604695 DOI: 10.1016/j.transci.2007.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2007] [Accepted: 03/20/2007] [Indexed: 11/22/2022]
Abstract
Data collection in the field of medicine is extremely important for patient safety. It is viewed as a quality issue in several countries around the world. In order to achieve this goal, nationwide apheresis registries were planned. In 2003, World Apheresis Association (WAA) decided to establish a world-wide apheresis registry. Although some of the apheresis centers in our country sent data to this registry, we believe that we need our own Turkish Registry. For this purpose, we launched new web based apheresis software for donor and therapeutic apheresis procedures. This paper summarizes the characteristics of this new software.
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Affiliation(s)
- Onder Arslan
- Ankara University, Faculty of Medicine, Department of Hematology, Blood Bank and Apheresis Unit, Ankara, Turkey.
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Pagnoux C. Plasma exchange for systemic lupus erythematosus. Transfus Apher Sci 2007; 36:187-93. [PMID: 17368988 DOI: 10.1016/j.transci.2007.01.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2004] [Accepted: 01/05/2007] [Indexed: 11/16/2022]
Abstract
Efficacy of plasma exchange in patients with systemic lupus erythematosus has not been supported by the results of the first non-controlled and retrospective studies. Nonetheless, they remain relevant for some selected patients with life-threatening manifestations and/or severe therapy-resistant manifestations. They can be used as an adjuvant therapy in combination with corticosteroids and, when required, other immunosuppressant(s) for refractory renal disease, alveolar hemorrhage, some neuropsychiatric manifestations, thrombotic thrombocytopenic purpura, catastrophic antiphospholipid syndrome, hyperviscosity syndrome or symptomatic cryoglobulinemia. The use of newer technologies, like immunoadsorption, possibly in combination with recent biologics, might, in the future, offer some new perspectives for extracorporeal therapy of systemic lupus erythematosus.
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Affiliation(s)
- Christian Pagnoux
- Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université René Descartes, Paris, 27, rue du Faubourg Saint-Jacques, 75689 Paris Cedex 14, France.
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Petitpas D, Ould-Zein S, Korach JM. What are the indications for plasma exchanges in autoimmune diseases?: The registry of the Société Française d’Hémaphérèse. Transfus Apher Sci 2007; 36:173-7. [PMID: 17382592 DOI: 10.1016/j.transci.2007.01.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2006] [Accepted: 01/05/2007] [Indexed: 12/11/2022]
Abstract
The use of plasma exchange (PE) in the autoimmune diseases is encouraged in France. Since 1990, the national registry of PE allows an analysis of the evolution of the coverage of these pathologies. The variation of the number of patients treated by PE is correlated in respect to the results of the therapeutic studies. After a decrease of PE activity in these indications during the 90s, one observes a new increase of the patients treated because of the validation of new indications. Autoimmune diseases represent the third cause of morbidity in developed countries, with a global prevalence of 5%, and concerns four groups of pathologies of organs or systems (neurology, haematology, nephrology and vasculitis). In 1976, Lockwood demonstrated the place of plasma exchanges (PE) in Goodpasture's syndrome [Lockwood CM, Rees AJ, Pearson TA, Evans DJ, Peters DK, Wilson CB. Immunosuppression and plasma exchange in the treatment of Goopasture's syndrome. Lancet 1976;1(7962):723-6. [1]], with a significant decrease of antibodies during large volume exchanges. In the 80s, several prospective studies began to estimate the efficiency of PE in other autoimmune diseases. The national registry of the Société Française d' Hémaphérèse, has collected the epidemiological and technical data of PE since 1985. This work analyses the evolution of the validated indications, between 1990 and 2005 in France.
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Affiliation(s)
- D Petitpas
- Intensive Care Unit, General Hospital, 51 Rue du Commandant Derrien, 51000 Châlons en Champagne, France
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Sousa P, Bazeley M, Johansson S, Wijk H. The use of national registries data in three European countries in order to improve health care quality. Int J Health Care Qual Assur 2006; 19:551-60. [PMID: 17100224 DOI: 10.1108/09526860610704178] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to highlight the role of national health registries in three European countries in order to improve patient care. DESIGN/METHODOLOGY/APPROACH The methodology used was a literature review of databases in Sweden, the UK and Portugal, and a search on Medline and Pubmed as well. In addition case studies from the three countries are included. FINDINGS In Sweden registries encompassing cardiac intensive care, hip-fractures and stroke are the most developed. In the UK, the collection of information on healthcare performance, both specific to particular specialties and general hospital performance, is widespread. There are some national and regional registries in Portugal, but the most developed areas are the Cardiovascular and the Oncology areas. The collection of information on health quality/performance indicators, based on administrative and clinical data is an important tool for quality improvement. ORIGINALITY/VALUE This paper showed differences and similarities between the three countries with a common aim; to improve quality of care, delivered on equal terms for the whole populations, and in an effective and efficient way and will be useful to those in the field of patient care.
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Affiliation(s)
- Paulo Sousa
- Universidade Nova de Lisboa, Lisbon, Portugal.
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Stegmayr B, Klingstedt J, Grahn BE, Vinnervik P. The new WAA apheresis registry. Transfus Apher Sci 2006; 34:259-62. [PMID: 16839818 DOI: 10.1016/j.transci.2005.12.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2005] [Accepted: 12/15/2005] [Indexed: 10/24/2022]
Abstract
The WAA (World Apheresis Association) registry for apheresis has been developed to enable registration through internet by centers all around the world. It is of no charge for the registering centers. The new version is available at the site www.iml.umu.se/medicin. Until now more than 5700 treatments have been registered from centers in 6 countries. It allows registration of acute or chronic therapeutic apheresis and also collection of stem cells, cellapheresis, photopheresis and various adsorption technologies. Registration includes diagnoses, access, anticoagulation, replacement fluids, mode of treatment, volumes processed, techniques used and adverse events that develop. Analyses of data enables improvement of quality of apheresis. The new registry enables you to change data that were wrongly entered as well as add data that was missed when you firstly entered the file. We cordially invite all of you to join the registration procedure.
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Affiliation(s)
- Bernd Stegmayr
- Division of Nephrology, Department of Internal Medicine, University Hospital of Northern Sweden and Institute for Interactive Learning and Education, Umea University, SE 901 85 Umea, Sweden.
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Pagnoux C, Korach JM, Guillevin L. Indications for plasma exchange in systemic lupus erythematosus in 2005. Lupus 2006; 14:871-7. [PMID: 16335578 DOI: 10.1191/0961203305lu2174rr] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Plasma exchange can remove putative pathogenic autoantibodies and circulating immune complexes from the blood of patients with systemic lupus erythematosus (SLE). However, their efficacy has only been supported by noncontrolled and/or retrospective studies. Nonetheless, PE may still be of relevance in some selected SLE patients and as adjunctive therapy, in combination with corticosteroids (CS) and other immunosuppressant(s). We review herein the principal historical steps of the use of plasma exchange to treat SLE, based upon the main trials and case reports that have highlighted its most pertinent indications. Acute life-threatening manifestations and severe therapy-resistant manifestations, like refractory SLE renal disease, diffuse alveolar hemorrhage, neuropsychiatric SLE, thrombotic thrombocytopenic purpura, catastrophic antiphospholipid syndrome, hyperviscosity syndrome and cryoglobulinemia, are the indications for which plasma exchange might have a beneficial therapeutic role. Although few SLE patients undergo plasma exchange each year nowadays (10-20 per year in France), adverse events are very rare and recent advances in plasma exchange technologies, like immunoadsorption, might, in the future, counterbalance their cost and broaden their place in the therapeutic armamentarium for SLE.
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Affiliation(s)
- C Pagnoux
- Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université René Descartes, Paris, France.
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Valbonesi M, Carlier P, Giannini G, Ruzzenenti MR. Rheotherapy for Vascular Disorders. Int J Artif Organs 2005; 28:1012-7. [PMID: 16288439 DOI: 10.1177/039139880502801008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Patients with vascular disorders are seldom offered apheresis in the management of their symptoms. In this article we review the different apheretical techniques used in these situations.
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Affiliation(s)
- M Valbonesi
- Department of Immunohematology, Immunohematology Services, S. Martino University Hospital, Genova--Italy
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Abstract
This article summarizes the current evolutions regarding artificial organs in Europe. The review emanates from the activities by four of the work groups of the European Society for Artificial Organs (ESAO) and is essentially based on the reports by these work groups at the latest ESAO meeting in Warsaw, Poland (2004). The topics are: apheresis, heart support, liver support, uremic toxins.
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Affiliation(s)
- Raymond Vanholder
- Nephrology Section, Department of Internal Medicine, University Hospital, Gent, Belgium.
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Stegmayr BG. A survey of blood purification techniques. Transfus Apher Sci 2005; 32:209-20. [PMID: 15784456 DOI: 10.1016/j.transci.2004.10.023] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2004] [Accepted: 10/01/2004] [Indexed: 11/16/2022]
Abstract
Apheresis may be performed with many different techniques. The basis for different therapeutic approaches lies in the pathophysiological processes present in the diseases that have to be treated. Over the years more sophisticated devices have been developed. The most frequent treatment is plasma exchange (plasmapheresis) using centrifugation or single filtration techniques. In addition cascade filtration and subsequent adsorption from plasma is done. Thereby removal is done by adsorption of molecules such as bilirubin, immunoglobulins (immunoadsorption), circulating immune complexes, various antibodies including those against blood types. Such adsorption technologies have also been developed to allow adsorption directly from a column perfused by whole blood (hemoperfusion). By combining various techniques, systems are available that allow bridging of patients with hepatic failure to transplantation (MARS, Prometheus). By adding e.g., hepatic cells to such systems, besides dialysis and adsorption, cells will help to degrade toxic molecules. Such bioreactors are in clinical use. Apheresis includes also the removal or retrieval of cells from blood for e.g., stemcell transplantation, polycythaemia or hemochromatosis. Removal of leukocytes from blood using leukocyte filters is indicated in inflammatory bowel diseases. By specifically irradiating lymphocytes and monocytes with UV light using the technique of extra corporeal photochemotherapy (ECTP) various immunological diseases are treated. On the other hand, various alternative techniques may be used for the same disorder. Thus for patients with high plasma LDL-cholesterol not responding to other lipid lowering strategic treatment, alternative therapy may be done either by cascade filtration, adsorption technology from plasma, heparin precipitation (HELP-system) or hemoperfusion. This article describes various techniques in clinical use.
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Affiliation(s)
- Bernd G Stegmayr
- Medicinkliniken, Norrlands Universitetssjukhus, 901 85 Umea, Sweden.
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Stegmayr BG, Ivanovich P, Korach JM, Rock G, Norda R, Ramlow W. World apheresis association—world apheresis registry. Transfus Apher Sci 2005; 32:205-7. [PMID: 15784455 DOI: 10.1016/j.transci.2004.10.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2004] [Accepted: 10/01/2004] [Indexed: 11/17/2022]
Abstract
In 2002 WAA decided to start a world-wide apheresis registry to gain insight into the extent of treatment, adverse events, and to facilitate contacts among centers when treatment indications are rare and experience limited. Stem cell and other blood products collections intended for therapeutic application can also be entered. The WAA planned to use the French Registry. Its translation into English has not been accomplished and the fiscal obligations for that registry has not, as yet, been determined or considered and approved by the WAA Board. From Dec 2002 the proposed registry (a merged version of the French, Canadian and Swedish registries) can be immediately implemented. We now cordially invite all centers to join that registry. Please, also inform colleagues at other centers in your country to join. E-mail and address lists of colleagues in your country who have not registered will be welcomed. The site is at: Go to World Apheresis Registry; Login code to test the Registry is: al61tms. Then apply for a specific login code for your center. We welcome you to this registry for your input of data. You will not be charged any registration fee. The registry includes a randomization system that can be used for local or multi center studies (randomization by in-center basis allows you to make your own studies). It includes a formula that increases the chance to get a more even distribution between groups also for smaller sample sizes.
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Affiliation(s)
- B G Stegmayr
- Medicinkliniken Norrlands Universitetssjukhus, 901 85 Umea, Sweden.
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Passalacqua S, Staffolani E, Busnach G, Roccatello D, Pasquali S, Cappelli P, Liuzzo G. The Italian Registry for Therapeutic Apheresis. A report from the Apheresis Study Group of the Italian Society of Nephrology. J Clin Apher 2005; 20:101-6. [PMID: 15880354 DOI: 10.1002/jca.20037] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Many clinical indications and different technical issues have been reported on therapeutic apheresis: much criticism has also been recorded in several instances, mainly due to the lack of large clinical trials to validate collected data. A Registry where all the available data can be organized and analyzed therefore becomes a priority for all the professionals involved in apheresis. The purpose of this report is to describe the data submitted from 1994 to 2004 from 15,285 treatments on 1,477 patients from 44 Centers, including mainly, but not exclusively, Nephrological Units, collected by the Apheresis Study Group of the Italian Society of Nephrology in 15 Italian regions. Plasma exchange accounted for 56.2% of the procedures, and of these 50.4% were performed by filtration. Plasma treatment was used in 40.1% of procedures, namely with Protein A immunoadsorption (14.6%), LDL-Cholesterol dextran sulfate adsorption (9.7%), and semiselective cascade or double filtration (12.6%). Cell apheresis, limited to photopheresis, was used in 0.85% of cases, and whole blood treatment (direct adsorption lipoprotein, and molecular adsorption recirculating system) in 2.7%. The procedures analyzed here account for less than 20% of estimated therapeutic apheresis performed in Italy, according to the national survey of activity performed for year 2000 by the Italian Apheresis Society. Notwithstanding that the data are largely incomplete, they are sufficiently informative for a definite trend: plasma treatment with filtration on fractionation filters and adsorption must be used as often as possible, instead of plasma exchange, thus obtaining the most selective removals.
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Stegmayr BG, Ivanovich P, Korach JM, Rock G, Norda R, Ramlow W. World apheresis registry. J Clin Apher 2005; 20:126-7. [PMID: 15880360 DOI: 10.1002/jca.20044] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- B G Stegmayr
- Medicinkliniken, Norrlands Universitetssjukhus, 901 85 Umea, Sweden
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Bosch T. State of the art of LDL-apheresis. Transfus Apher Sci 2004. [DOI: 10.1016/j.transci.2004.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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