Impact of saline infusion and citrate infusion rate during donor plasmapheresis.

The purpose of our research was to evaluate the effects of saline infusion to counteract incidents of severe hypotension during donor plasmapheresis (DP; synonym with plasma donation), and on immunoglobulin G (IgG) content in collected plasma, and on donor hematological values. It examines the clearance (Cl) of IgG during DP without saline to calculate the distribution of citrate and citrate infusion rate (CIR) during DP. It is based on three studies: an observation of saline infusion in donors with severe drops in blood pressure at DP, and two crossover trials of 32 repeat plasma donors each on saline infusion during DP.

Donor safety in an individualized plasmapheresis program - Results of an interim analysis.

Background And Objectives: Although plasma donation by plasmapheresis is generally considered to be safe, there are still concerns about the long-term effects of intensive plasma donation on the levels of certain blood components, such as immunoglobulin G (IgG). The IPS study aims to assess donor safety during individualized plasma donation according to pre-donation IgG levels and body weight compared with plasma donation under current German guidelines.

Study Design And Methods: This ongoing prospective multicenter study allows eligible donors to choose between an individualized plasma donation program or plasma donation according to current German guidelines.

Safety of Plasmapheresis in Donors with Low IgG Levels: Results of a Prospective, Controlled Multicentre Study.

Background And Objectives: Although plasmapheresis is generally considered safe, there are still concerns about the long-term effects of plasma donation on immunoglobulin G (IgG) levels. The aim of the present study was to investigate if there is a need to permanently defer donors who donated three times with an IgG level below 6.0 g/L.

Anticoagulation, bleeding, and clotting at donor plasmapheresis.

This article is based on a question of a colleague from North America how coagulation could be triggered between a donor's arm and a fistula needle during plasma donation (synonymous with donor plasmapheresis). The technique of venipuncture and citrate anticoagulation are described. Uncommon and rare problems such as prolonged bleeding, scarring, and thrombosis in plasma donors are discussed.

Report on 50 cases of severe acute hypotension at donor plasmaphereses: treatment and course.

Introduction: This paper reports our experience in 50 cases with severe hypotensive reactions at plasma donations (synonymous with donor plasmaphereses).

Methods: Plasma donors who developed a severe acute hypotensive reaction at donor plasmapheresis, and were treated by placing the donor in the Trendelenburg position and rapid infusion of 1,000 mL saline were investigated. Plasmaphereses were performed with the Haemonetics® plasma collecting system 2 (PCS2).

Distribution of citrate and citrate infusion rate during donor plasmaphereses.

Background: The purpose of this study was to describe the distribution of trisodium-citrate 4% (TSC) anticoagulant (AC) between the product and the donors undergoing plasma donation.

Subjects And Methods: Data of 32 regular donors of plasma initially collected for a study published in 2010 were re-analyzed to determine the amount of citrate received by the donor and the citrate infusion rate (CIR) in mg/kg/min to the donor. Donor plasmaphereses (DP) were performed with the automated Haemonetics plasma collecting system 2 (PCS2).

Course of Hemoglobin and Hematocrit during and after Preparatory Plasmaphereses without and with Infusion of NaCl 0.9% 500 ml.

Background: The aim of this study was to evaluate the course of hemoglobin (HGB) concentration and hematocrit (HCT) in donor blood during and after preparatory plasmaphereses (PP) without NaCl and with an infusion of 500 ml 0.9% NaCl during PP.

Methods: After informed consent 32 plasma donors were studied in a crossover design.

Loss of red cell mass in a plasmapheresis machine: effect of rinsing the disposable tubing with normal saline and reinfusion.

The aim of this study was to determine the loss of red cell mass during a plasma donation. If the donor undergoes plasmapheresis 45 times within one year without rinsing the tubing system and reinfusing this normal saline into the donor at the end of the donation, the result is a loss of red cell mass of 11.01 ml per donation.

Influence of NaCl 0.9% Infusion during Plasmapheresis on IgG Content in Plasma.

BACKGROUND: The aim of this study was to evaluate the influence of an infusion of NaCl 0.9% 500 ml during preparatory plasmapheresis or apheresis on the immunoglobulin G (IgG) content in separated plasma. METHODS: 32 donors of plasma were studied in a crossover design after informed consent on one day without NaCl 0.

ProTime self-management yielding improvement of fluency and quality of life.

Patient self-management (PSM), as the standard of care for vitamin K-antagonist therapy management in Germany requires a detailed, point-of-care (POC) device-specific training program to ensure quality patient care. In a multi-center trial using the ProTime System (Training program plus POC device), 105 patients were enrolled to evaluate efficacy of training, knowledge retention, patient satisfaction and quality of life (QoL). Patients returned to the centers 1, 3 and 6 months after training to complete questionnaires and demonstrate INR test proficiency.

Low-dose oral anticoagulation in patients with mechanical heart valve prostheses: final report from the early self-management anticoagulation trial II.

Aims: In mechanical heart valve recipients, low-dose international normalized ratio (INR) self-management of oral anticoagulants can reduce the risk of developing thrombo-embolic events and improve long-term survival compared with INR control by a general practitioner. Here, we present data on the safety of low-dose INR self-management.

Methods And Results: In a prospective, randomized multi-centre trial, 1346 patients with a target INR range of 2.

Enzyme linked immunosorbent assay (ELISA) as screening method for anti-paternal allo-antibodies in patients with recurrent pregnancy loss (RPL).

Objectives: Non-HLA-specific anti-paternal antibodies (APA) have been associated with immune responses against HLA-negative trophoblast. As screening for APA by using the flow cytometric cross match (FCXM) is complicated, we evaluated the One Lambda Antigen Tray Test (OLATT) an easy screening method for antibodies in organ transplant recipients.

Study Design: We randomly selected 92 patients of our recurrent pregnancy loss (RPL)-clinic merely on the basis of having had at least two consecutive miscarriages at <20 weeks representing positive and negative FCXM results.

Low-dose international normalized ratio self-management: a promising tool to achieve low complication rates after mechanical heart valve replacement.

Background: International normalized ratio (INR) self-management can significantly reduce INR fluctuations, bleeding, and thromboembolic events compared with INR control managed by general practitioners. However, even patients with INR self-management may have an increased risk of bleeding if their INR value is above 3.5.

Analytical performance of the new coagulation monitoring system INRatio for the determination of INR compared with the coagulation monitor Coaguchek S and an established laboratory method.

An evaluation of the INRatio Prothrombin Time Monitoring system for determination of INR was done in two centers with a total of 5 healthy subjects and 77 subjects on oral anticoagulation. The INRatio and the Coaguchek S were compared with an established laboratory method. The correlation coefficient of the comparison with the laboratory was r=0.

Self management of oral anticoagulation with the IN Ratio system: impact of a structured teaching program on patient's knowledge of medical background and procedures.

Background: Self management of oral anticoagulation (OAC) decreases complication rates and improves quality of life. Manual and cognitive abilities of patients and patient training in a structured format are a precondition for this concept. Up to now, there is no evidence about knowledge increase from teaching programs.

Post-operative course of coronary artery bypass surgery patients who pre-donate autologous blood.

Background: Pre-operative autologous blood donation is used to reduce the need of allogeneic blood in patients undergoing coronary bypass surgery operations, but it is not clear what impact the blood donation has on the post-operative course of these patients.

Methods: We studied the post-operative course of 210 patients who pre-donated autologous blood before their coronary bypass operation (donors) and of 67 patients who were eligible to pre-donate but did not (controls).

Results: The clinical variables and the technical operative parameters of the patients in the two groups were similar.

In vitro biocompatibility evaluation of the dynamic bubble trap.

The goal of this study was to evaluate the biocompatibility of the dynamic bubble trap (DBT) prior to the clinical trial. It was set up as an in vitro model, which simulates physiological conditions. Twenty runs were performed (ten with the DBT, ten without the DBT) at a blood flow of 3 l/min, each lasting 180 min.

Low-density lipoproteins induce the polar secretion of PAI-1 by endothelial cells in culture.

Patients with hypercholesterolemia and with coronary atherosclerosis have increased plasma levels of plasminogen activator inhibitor (PAI)-1. PAI-1 and low-density lipoproteins (LDL) are also present in the walls of atherosclerotic vessels, where they participate in the development and remodeling of the atherosclerotic plaques. We investigated the influence of LDL on the apical (luminal) and basolateral (subendothelial) secretion of PAI-1 by human umbilical vein endothelial cells in a two-compartment cell-culture model.