二重膜濾過血漿交換 double-filtration plasmapheresis

English Journal

Successful ABO incompatible renal transplantation following rituximab and DFPP after failed immunoadsorption.

Thalgahagoda S1, Webb NJ, Roberts D, Birch A, Milford DV, Tavakoli A, Shenoy M.Author information 1Department of Paediatric Nephrology, Royal Manchester Children's Hospital, Manchester, UK.AbstractEffective antibody removal using PE, DFPP and IA has led to increased access to live donor organs through ABOi RT for patients with chronic kidney disease. However, there have been no head-to-head comparator studies between these modalities, and the choice of technique is usually influenced by cost and institutional preference. We describe the clinical course of a child undergoing ABOi RT, in whom IA without preconditioning with rituximab did not achieve a satisfactory reduction in the antibody titers, who went on to have a successful living donor RT following rituximab and DFPP.
Pediatric transplantation.Pediatr Transplant.2014 May;18(3):E74-6. doi: 10.1111/petr.12227. Epub 2014 Feb 1.
Effective antibody removal using PE, DFPP and IA has led to increased access to live donor organs through ABOi RT for patients with chronic kidney disease. However, there have been no head-to-head comparator studies between these modalities, and the choice of technique is usually influenced by cost
PMID 24483150

Current topics in therapeutic plasmapheresis.

Nakanishi T1, Suzuki N, Kuragano T, Nagasawa Y, Hasuike Y.Author information 1Division of Kidney and Dialysis, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan, t-nkns@hyo-med.ac.jp.AbstractTherapeutic plasmapheresis has been used for intractable diseases that cannot be cured by conventional drug therapy. Currently, the use of therapeutic plasmapheresis has been approved for 27 diseases by Japan's National Health Insurance system and is mainly categorized into three modalities: plasma exchange (PE), double-filtration plasmapheresis (DFPP), and plasma adsorption (PA). Plasma separators and/or fractionators are essential for the therapy. PE is performed for two purposes: removal of pathogenic antigens or substances in the plasma fraction and supplementation of essential factors, such as albumin and coagulation factors. PE can be used for thrombotic microangiopathy and acute hepatic failure. DFPP can be performed for selective removal of macromolecules while avoiding the use of substitution fluid (i.e., albumin or fresh frozen plasma). DFPP has now been used for conditions involving relatively larger plasma molecules, including hyperviscosity syndrome and ABO-incompatible kidney transplantation. PA can specifically remove pathogenic agents, such as low-density lipoprotein or autoantibodies, in the IgG fractions by the adsorption column and does not require substitution fluids. PA has now been used for a wide variety of neurological diseases, including chronic inflammatory demyelinating polyneuropathy. This review describes the characteristics of each modality, seeking to improve the efficacy and specificity of removal of the target substance.
Clinical and experimental nephrology.Clin Exp Nephrol.2014 Feb;18(1):41-9. doi: 10.1007/s10157-013-0838-0. Epub 2013 Jul 26.
Therapeutic plasmapheresis has been used for intractable diseases that cannot be cured by conventional drug therapy. Currently, the use of therapeutic plasmapheresis has been approved for 27 diseases by Japan's National Health Insurance system and is mainly categorized into three modalities: plasma
PMID 23887747

[An autopsy case of amyotrophic lateral sclerosis with prominent muscle cramps, fasciculation, and high titer of anti-voltage gated potassium channel (VGKC) complex antibody].

Sato A1, Sakai N, Shinbo J, Hashidate H, Igarashi S, Kakita A, Yamazaki M.Author information 1Department of Neurology, Niigata City General Hospital.AbstractThe patient was a 55-year-old male who had prominent fasciculation and muscle cramps. Muscle weakness and atrophy of the trunk, respiratory system, and extremities gradually progressed. On the basis of these features, we diagnosed this patient as having amyotrophic lateral sclerosis (ALS), however, the upper motor neuron signs were not significant. Following the detection of the anti-voltage gated potassium channel (VGKC) complex antibody at 907.5 pM (normal < 100 pM) and repetitive discharge in a nerve conduction study, immunotherapy with intravenous immunoglobulin, methylprednisolone (mPSL), double filtration plasmapheresis (DFPP), ciclosporin, and rituximab was introduced. mPSL and DFPP showed only tentative effectiveness for fasciculation and muscle cramps, respectively. Thereafter, muscle weakness progressed. The patient died of type II respiratory failure at the age of 57 years, about 2 years after the onset of the disease. At autopsy, a histopathological diagnosis of ALS with lower-motor-predominant degeneration was made. Characteristic cellular features, including Bunina bodies in the remaining lower motor neurons and phosphorylated TAR DNA-binding protein 43-kDa (pTDP-43)-immunopositive inclusions in both upper and lower motor neuron systems, were evident. At present, an immunological role of the anti-VGKC complex antibody in the development of cramp-fasciculation syndrome has been speculated. In this ALS patient, the antibodies might be associated with pathomechanisms underlying the characteristic symptoms.
Rinshō shinkeigaku = Clinical neurology.Rinsho Shinkeigaku.2014;54(1):32-7.
The patient was a 55-year-old male who had prominent fasciculation and muscle cramps. Muscle weakness and atrophy of the trunk, respiratory system, and extremities gradually progressed. On the basis of these features, we diagnosed this patient as having amyotrophic lateral sclerosis (ALS), however,
PMID 24429646

Japanese Journal

Genotype 1型高ウイルス量C型慢性肝炎患者(初回治療例)における二重濾過血漿交換法(DFPP)併用ペグインターフェロン+リバビリン(PEG-IFN+RBV)療法の有効性に関する検討

中谷泰樹,東俊二郎,野口未央,籔内洋平,松本久和,太田彩貴子,信岡未由,三上貴生,岩上裕吉,津田喬之,三長孝輔,李宗南,中村文保,谷口洋平,赤松拓司,瀬田剛史,浦井俊二,上野山義人,山下幸孝
日本赤十字社和歌山医療センター医学雑誌 = Medical Journal of Japanese Red Cross Society Wakayama Medical Center 30, 63-72, 2012-12-00
… pheresis:DFPP)を併用したペグインターフェロン+リバビリン(PEG-IFN+RBV)治療を行い、治療効果と安全性について検討した.Early virological response(EVR)率はDFPP群76.7%,非DFPP群56.3%であり,DFPP群で有意に高い結果となった(P<0.05).さらにEVR症例におけるその後のウイルス持続陰性化(sustained virological response:SVR)到達率は,DFPP群77%,非DFPP群73.2% …
NAID 120005294739

透析会誌45(4) : 363-366, 2012「Rh(E)血液型不適合妊娠に double filtration plasmapheresis (DFPP) を施行した1例』森澤洋介, ほかの論文について

森澤洋介,吉田克法
日本透析医学会雑誌 = Journal of Japanese Society for Dialysis Therapy 45(9), 897-898, 2012-09-28
NAID 10031123038

ABO血液型不適合腎移植における術前アフェレシス療法の置換液組成とその抗体除去効果および安全性の検討

津田圭一,酒井謙,元木康裕 [他],室市秀久,舘野琢哉,小山信彌,村松真樹,河村毅,相川厚
日本透析医学会雑誌 = Journal of Japanese Society for Dialysis Therapy 45(8), 645-650, 2012-08-28
慢性腎不全患者には血液透析，腹膜透析，腎移植の選択肢があるなか，腎移植を希望する患者が増加している．特に移植ドナーの少ないわが国では，ABO式血液型不適合腎移植が増加傾向を示すが，ABO式血液型不適合腎移植をする場合には，抗血液型抗体である抗A抗B抗体の除去をするためにアフェレシス療法が必要となる．そこで今回，当院においてABO式血液型不適合腎移植に対する二重膜濾過血漿分離交換法での置換液のアルブ …
NAID 10031064035