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Complement activation as a cause of transient hypotension during plasmapheresis
Y Shiga1, K Fujihara, H Onodera
1Department of Neurology, Tohoku University School of Medicine, Sendai, Japan.
Artificial Organs
|January 6, 1999
Summary
Transient hypotension during plasmapheresis (PP) is linked to activated complement proteins. Elevated levels of C3a and C5a were observed in patients experiencing hypotension, suggesting their role in this common adverse effect.
Area of Science:
- Nephrology
- Immunology
- Critical Care Medicine
Background:
- Hypotension is a frequent adverse effect of plasmapheresis (PP).
- Existing theories attribute hypotension to hypovolemia or vasovagal responses.
- Complement activation during PP is known, producing vasodilatory anaphylatoxins.
Purpose of the Study:
- To investigate the relationship between transient hypotension and plasma levels of activated complement components during plasmapheresis.
- To determine if complement activation plays a role in PP-induced hypotension.
Main Methods:
- Studied 7 patients over 8 plasmapheresis sessions.
- Utilized Plasmafro OP-08 for plasma separation.
- Employed immunoadsorption (IM-TR 350/IM-PH 350) or double filtration (Evaflux 4A) techniques.
- Measured plasma levels of activated complements C3a and C5a during and after PP.
Main Results:
- Four out of eight sessions were associated with transient hypotension.
- Patients experiencing hypotension showed significantly elevated plasma levels of activated complements C3a and C5a.
- Patients without hypotension did not exhibit increased C3a and C5a levels.
Conclusions:
- Activated complement components, specifically C3a and C5a, play a critical role in causing transient hypotension during plasmapheresis.
- This finding offers a new perspective on managing hypotension during PP.