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Extracorporeal Removal of Drugs: Hemoperfusion and Hemofiltration01:25

Extracorporeal Removal of Drugs: Hemoperfusion and Hemofiltration

Hemoperfusion and hemofiltration are critical techniques in medical treatments to eliminate accumulated drugs, metabolites, and electrolytes from the bloodstream. These methods are particularly vital in cases of accidental poisoning and drug overdose.Hemoperfusion involves passing blood through an adsorbent material to remove unwanted substances. The main adsorbents used in hemoperfusion include activated charcoal and Amberlite resins. Activated charcoal can adsorb both polar and nonpolar...
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Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in critically...
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Basic Research in Plasma Medicine - A Throughput Approach from Liquids to Cells
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Published on: November 17, 2017

Current topics in therapeutic plasmapheresis.

Takeshi Nakanishi1, Naoki Suzuki, Takahiro Kuragano

  • 1Division of Kidney and Dialysis, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan, t-nkns@hyo-med.ac.jp.

Clinical and Experimental Nephrology
|July 27, 2013
PubMed
Summary

Therapeutic plasmapheresis, including plasma exchange (PE), double-filtration plasmapheresis (DFPP), and plasma adsorption (PA), offers advanced treatment for intractable diseases. This review details each modality to enhance the removal of target substances for improved patient outcomes.

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Area of Science:

  • Nephrology
  • Hematology
  • Neurology

Background:

  • Therapeutic plasmapheresis is crucial for intractable diseases unresponsive to conventional drug therapy.
  • Japan's National Health Insurance approves plasmapheresis for 27 diseases.
  • Key modalities include plasma exchange (PE), double-filtration plasmapheresis (DFPP), and plasma adsorption (PA).

Purpose of the Study:

  • To review the characteristics of different therapeutic plasmapheresis modalities.
  • To enhance the efficacy and specificity of removing target substances.
  • To provide insights into selecting appropriate plasmapheresis techniques.

Main Methods:

  • Description of plasma exchange (PE) for removing pathogenic substances or supplementing factors.
  • Explanation of double-filtration plasmapheresis (DFPP) for selective macromolecule removal without substitution fluids.
  • Overview of plasma adsorption (PA) for specific removal of agents like LDL or autoantibodies using adsorption columns.

Main Results:

  • PE is effective for thrombotic microangiopathy and acute hepatic failure.
  • DFPP is utilized for conditions with larger molecules, such as hyperviscosity syndrome and ABO-incompatible kidney transplantation.
  • PA is applied to neurological diseases, including chronic inflammatory demyelinating polyneuropathy, for targeted substance removal.

Conclusions:

  • Each plasmapheresis modality (PE, DFPP, PA) possesses unique characteristics and applications.
  • Understanding these differences is key to optimizing treatment for various intractable diseases.
  • Further refinement in modality selection can improve therapeutic efficacy and specificity.