[Discontinuous plasma exchange with the conventional hemodialysis technic and blood cell centrifugation]

A conventional haemodialysis system, to which the patient is connected as for acute dialysis, forms the basis of the plasma substitution method. At each session around 2 litres of plasma were exchanges within 3 hours. Freshly frozen donor plasma was mainly used as the substitution solution. A total of 20 substitutions were carried out in 5 patients in a period of 7 months. The indications were: 3 x major mismatch in the ABO system before bone marrow transplantation, myasthenic crisis, violent attacks connected with lupus erythematosus with rapid development of renal insufficiency. The therapeutic goal of quickly eliminating immunopathogenetic proteins was achieved in all cases. It was possible to reduce the level of isoagglutinins, haemolysins, autoantibodies (myasthenia gravis) and immunity complexes (LE) effectively. The clinical course confirmed the excellent effectivity. There were no serious complications despite the serious primary diseases. Volume imbalances, changes of body temperature, precipitations of cryoglobulins, electrolyte disturbances or citrate intoxications were always well controllable thanks to the combination of plasma substitution and dialysis.