Title: Major coagulation disturbances during fractionated plasma separation and adsorption
Authors: Meijers, Bj√∂rn
Verhamme, Peter
Nevens, Frederik
Hoylaerts, Marc
Bammens, Bert
Wilmer, Alexander
Arnout, Jozef
Vanrenterghem, Yves
Evenepoel, Pieter # ×
Issue Date: Sep-2007
Publisher: Munksgaard International Publishers
Series Title: American Journal of Transplantation vol:7 issue:9 pages:2195-2199
Abstract: Fractionated Plasma Separation and Adsorption (FPSA) is a novel nonbiologic detoxification system for the removal of protein-bound solutes. FPSA is used to bridge patients during fulminant liver failure, either to functional recovery or to liver transplantation. Besides liver failure associated protein bound solutes, several important uremic retention solutes share important protein binding. We observed repeated occlusive thrombosis of the arterio-venous conduit during FPSA in hemodialysis (HD) patients, resulting in acute loss of function. A major reduction of several coagulation factors was demonstrated, exceeding 50% for factor II, factor X and protein C. Broad disturbances of the coagulation system were confirmed in FPSA treated liver failure patients. An ex vivo recirculation model demonstrated nonspecific adsorption of coagulation factors protein S and protein C on the anion exchange cartridge. Direct contact between fractionated plasma and the Prometh02 anion exchanger causes significant adsorption of procoagulant and anti-coagulant factors, associated with clinically relevant adverse events.
ISSN: 1600-6135
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory of Nephrology
Molecular and Vascular Biology
Laboratory for Clinical Infectious and Inflammatory Disorders
Biomedical Sciences Group Management - miscellaneous
× corresponding author
# (joint) last author

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