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Related Concept Videos

Ion Exchange01:17

Ion Exchange

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Ion exchange chromatography separates charged molecules from a solution by reversibly exchanging them with mobile, or 'active', ions associated with the oppositely charged stationary phase. This method can be used to separate ions, soften and deionize water, and purify solutions. The polymers comprising the ion-exchange column are high-molecular-weight and chemically stable polymers, crosslinked to be porous and essentially insoluble. They are also functionalized with either acidic or...
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Extracorporeal Removal of Drugs: Hemoperfusion and Hemofiltration01:25

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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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Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis01:30

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Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...
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Ion-Exchange Chromatography01:09

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Ion-exchange chromatography, or IEC, is a technique for separating ions based on their affinity for the stationary phase. The stationary phase is a cross-linked polymer resin with covalently attached ionic functional groups. The functional groups can be either positively charged (cation exchangers) or negatively charged (anion exchangers). A cation exchanger consists of a polymeric anion and active cations, while an anion exchanger is a polymeric cation with active anions. The choice of...
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Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy01:26

Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy

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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...
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Size-Exclusion Chromatography01:08

Size-Exclusion Chromatography

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In size-exclusion chromatography (SEC), also known as molecular-exclusion or gel-permeation chromatography, molecules are separated based on their sizes. This technique is important for separating large molecules such as polymers and biomolecules. The two classes of micron-sized stationary phases encountered in SEC are silica particles and cross-linked polymer resin beads. Both materials are porous, but their pore sizes vary significantly.
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Protein Digestion, Ultrafiltration, and Size Exclusion Chromatography to Optimize the Isolation of Exosomes from Human Blood Plasma and Serum
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Protein Digestion, Ultrafiltration, and Size Exclusion Chromatography to Optimize the Isolation of Exosomes from Human Blood Plasma and Serum

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Selective plasma exchange.

Atsushi Ohkubo1, Tomokazu Okado1

  • 1Department of Hemopurification, Medical Hospital of Tokyo Medical and Dental University, Japan.

Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis
|September 24, 2017
PubMed
Summary

Selective plasma exchange (SePE) offers a safer alternative for IgG removal, retaining vital coagulation factors. This method minimizes bleeding risks compared to traditional plasmapheresis.

Keywords:
Coagulation factorMembrane plasma separatorPlasma volumeSelective plasma exchangeSieving coefficientSupplementary fluid

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Area of Science:

  • Nephrology
  • Immunology
  • Blood Purification

Background:

  • Conventional plasma exchange (PE) can lead to the non-specific removal of essential plasma proteins, including coagulation factors.
  • This non-specific removal increases the risk of bleeding complications during plasmapheresis procedures.
  • A need exists for plasmapheresis techniques that selectively target pathogenic substances while preserving crucial physiological components.

Purpose of the Study:

  • To introduce and evaluate Selective Plasma Exchange (SePE) using the Evacure EC-4A10 (EC-4A) separator.
  • To determine the efficacy of SePE in removing Immunoglobulin G (IgG) while retaining coagulation factors.
  • To assess the safety profile of SePE, particularly concerning bleeding risk, compared to other plasmapheresis modalities.

Main Methods:

  • Utilized the Evacure EC-4A10 (EC-4A) selective membrane plasma separator with a small pore size (0.03μm).
  • Measured sieving coefficients for albumin, IgG, Factor XIII (FXIII), and fibrinogen using the EC-4A separator.
  • Calculated the approximate percentage of IgG removal per SePE session.

Main Results:

  • SePE demonstrated a sieving coefficient of 0.5 for IgG, enabling approximately 50% IgG removal per session.
  • Crucial coagulation factors like FXIII (sieving coefficient 0.17) and fibrinogen (sieving coefficient 0) were largely retained.
  • The retention of coagulation factors suggests a potentially lower risk of bleeding compared to conventional PE.

Conclusions:

  • Selective Plasma Exchange (SePE) is a viable and safe option for therapies targeting IgG removal.
  • SePE effectively removes IgG while preserving essential coagulation factors, thereby mitigating bleeding risks.
  • Combining SePE with conventional PE may offer a dual benefit of pathogen removal and factor retention when treating conditions involving various immunoglobulins.