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Related Experiment Videos

Different cascade filtration operating modalities in clinical use.

G Busnach1, A Dal Col, B Brando

  • 1Department of Nephrology, Niguarda Cà Granda Hospital, Milan, Italy.

The International Journal of Artificial Organs
|November 1, 1988
PubMed
Summary
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Cascade filtration (CF) offers comparable clinical performance in dead-end and single-pass configurations for treating blood disorders. Both methods achieve similar removal of IgM, with slight advantages for single-pass CF in albumin and IgG removal.

Area of Science:

  • Nephrology
  • Blood Purification
  • Plasma Exchange

Background:

  • Cascade filtration (CF) has two configurations: single-pass and dead-end.
  • Dead-end CF theoretically offers higher solute removal but is variable.
  • Single-pass CF offers constant but lower solute removal; filter plugging is a concern in both.

Purpose of the Study:

  • To compare the clinical efficacy of dead-end CF (QP) versus modified single-pass CF (QD).
  • To evaluate solute removal, specifically albumin, IgG, and IgM, in patients with cryo- and macroglobulinemia.
  • To assess operational parameters including filter plugging and washouts.

Main Methods:

  • A comparative study involving 10 patients undergoing dead-end CF (QP) and 11 patients undergoing modified single-pass CF (QD).

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  • Patients had cryo- or macroglobulinemia; centrifugal plasma separation was used.
  • Secondary filters of 0.8 and 1.2 sq.m. surface area were employed; no exogenous reinfusions were administered.

    • Main Results:

    • Both QP and QD showed comparable removal of IgM (47.5% vs 48%).
    • QD demonstrated slightly higher removal of albumin (30.5% vs 25.8%) and IgG (40.5% vs 32%) compared to QP.
    • Filter plugging occurred in both groups, with QP requiring more washouts per run (2.3 vs 1.5).

    Conclusions:

    • Both dead-end and modified single-pass CF configurations are clinically viable for treating specific blood disorders.
    • Adequate filter surface area is crucial for achieving similar performance between the two CF methods.
    • The choice between QP and QD may depend on specific clinical goals, with QD showing a slight edge in albumin and IgG removal.