• Szu-Yu Pan, Tao-Min HuangThomasTDivision of Nephrology, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei City, Taiwan. Electronic address: taomin.huang@gmail.com., Yi-Chan Lin, Hui-Ting Liu, Sheng-Chieh Chou, Chih-Yuan Lee, Chien-Chia Chen, Chuan-Hsiu Fu, Chi-Chao Chao, and Vin-Cent Wu.
• Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei City, Taiwan; Department of Integrated Diagnostics & Therapeutics, National Taiwan University Hospital, Taipei City, Taiwan.
• J Formos Med Assoc. 2024 Aug 1; 123 (8): 899903899-903.

Background/PurposeDouble-filtration plasmapheresis (DFPP) can be used to remove circulating pathogenic molecules. By reclaiming filtered albumin, DFPP reduces the need for albumin and plasma replacement. Large proteins, such as fibrinogen, are removed. Our institution adopts a DFPP treatment protocol consisting of active surveillance of coagulation profiles and prophylactic supplementation of blood products containing fibrinogen. This study aims to investigate the effects of consecutive DFPP treatments on serial coagulation profiles and the risk of bleeding under this protocol.MethodsSerial laboratory data and bleeding events at a single tertiary medical center were prospectively collected. Prophylactic transfusion of cryoprecipitate or fresh frozen plasma (FFP) was instituted if significant coagulopathy or a clinically evident bleeding event was observed.ResultsAfter the first treatment session, plasma fibrinogen levels decreased from 332 ± 106 mg/dL to 96 ± 44 mg/dL in the 37 study patients. In the following sessions, plasma fibrinogen levels were maintained at around 100 mg/dL under prophylactic transfusion. No major bleeding events were recorded, but five (14%) patients experienced minor bleeding.ConclusionDFPP treatment might be performed safely along with active monitoring of coagulation profiles and prophylactic transfusion of cryoprecipitate or FFP.Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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