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World Journal of Transplantation 2024年第4期14卷 133-139页

作者： Sophie Gharaei Hashim Abbas Durga Anil Kanigicherla Manchester Medical School University of ManchesterManchester M139WLUnited Kingdom Department of Renal Medicine Manchester University NHS Foundation TrustManchester M139WLUnited Kingdom

BACKGROUND Focal segmental glomerulosclerosis(FSGS)often recurs after transplantation,leading to graft dysfunction and graft *** who have lost prior grafts due to recurrence are at particularly high risk of re-recurrence in subsequent *** and plasma exchange have been used pre-emptively to prevent post-transplant ***,the efficacy of such preventative measures remains *** To investigate the outcomes of preventative rituximab and plasma exchange for recurrent FSGS in transplant recipients after prior graft *** We conducted a systematic review of 11 studies with 32 patients who had experienced prior graft loss due to post-transplant FSGS recurrence and were treated with either pre-emptive plasma exchange alone,rituximab alone,or a combination of *** Overall,47%of the 32 patients experienced recurrence despite prophylactic ***-recurrence was seen in 25%(1/4)with pre-emptive rituximab alone,and 45%recurrence(9/20)with plasma exchange ***-recurrence was noted in 63%with the use of combined plasma exchange and *** There is a paucity of available evidence in the literature to draw clear conclusions on the benefits of pre-emptive measures to prevent FSGS *** small sample sizes and variations in protocols call for larger and controlled studies to serve this patient population at high risk of recurrence and graft loss.

关键词： Focal segmental glomerulosclerosis Glomerular disease plasma exchange Rituximab Transplantation

plasma exchange-centered artificial liver support system in hepatitis B virus-related acute-onchronic liver failure:a nationwide prospective multicenter study in China

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Hepatobiliary & Pancreatic Diseases International 2016年第3期15卷 275-281页

作者： Jia-Jia Chen Jian-Rong Huang Qian Yang Xiao-Wei Xu Xiao-Li Liu Shao-Rui Hao Hui-Fen Wang Tao Han Jing Zhang Jian-He Gan Zhi-Liang Gao Yu-Ming Wang Shu-Mei Lin Qing Xie Chen Pan Lan-Juan Li State Key Laboratory for Diagnosis and Treatment of Infectious Diseases and Collaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesFirst Affiliated HospitalZhejiang University School of Medicine Liver Failure Therapy and Research Center 302 Hospital of People’s Liberation Army Department of Hepatology Third Central Clinical College of Tianjin Medical University Artificial Liver Center You’an HospitalCapital Medical University Department of Infectious Diseases First Affiliated Hospital of Suzhou University Department of Infectious Diseases Third Affiliated Hospital of Sun Yat-Sen University Institute of Infectious Diseases Southwest HospitalThird Military Medical University Department of Infectious Diseases First Affiliated Hospital of Xi’an Jiaotong University Department of Infectious Diseases Ruijin HospitalShanghai Jiaotong University School of Medicine Department of Infectious Diseases Infectious Diseases Hospital Affiliated to Fujian Medical University

BACKGROUND： plasma exchange （PE）-centered artificial liver support system reduced the high mortality rate of hepa titis B virus （HBV）-related acute-on-chronic liver failure （ACLF）. But the data were diverse in different medical centers. The present prospective nationwide study was to evaluate the effects of PE on patients with HBV-ACLF at different stages.

关键词： liver failure artificial liver support plasma exchange acute-on-chronic liver failure

plasma exchange in patients with acute and acute-on-chronic liver failure: A systematic review

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World Journal of Gastroenterology 2020年第2期26卷 219-245页

作者： Eunice Xiang-Xuan Tan Min-Xian Wang Junxiong Pang Guan-Huei Lee National University Health System Singapore 119228Singapore Centre for Infectious Disease Epidemiology and Research Saw Swee Hock School of Public HealthNational University of SingaporeSingapore 119077Singapore National University of Singapore Singapore 119077Singapore

BACKGROUND Acute liver failure(ALF)and acute-on-chronic liver(ACLF)carry high short-term mortality rate,and may result from a wide variety of *** exchange has been shown in a randomized control trial to improve survival in ALF especially in patients who did not receive a liver *** cohort studies demonstrated potential improvement in survival in patients with *** To assess utility of plasma exchange in liver failure and its effect on mortality in patients who do not undergo liver *** Databases MEDLINE via PubMed,and EMBASE were searched and relevant publications up to 30 March,2019 were *** were included if they involved human participants diagnosed with liver failure who underwent plasma exchange,with or without another alternative non-bioartificial liver assist *** Three hundred twenty four records were reviewed,of which 62 studies were found to be *** the 262 records screened,211 studies were ***-one articles were assessed for eligibility,for which 7 were ***-nine studies were included for ALF only,and 9 studies for ACLF *** studies included both ALF and ACLF patients.A total of 44 publications were *** the included publications,2 were randomized controlled trials,14 cohort studies,12 case series,16 case *** of three ALF studies which looked at survival rate or survival days reported improvement in outcome with plasma *** two out of four studies where plasma exchange-based liver support systems were compared to standard medical treatment(SMT)for ACLF,a biochemical improvement was *** in the non-transplanted patients was improved in all four studies in patients with ACLF comparing plasma exchange vs *** the aforementioned studies,plasma exchange based therapy in ACLF compared to SMT improved survival in non-transplanted patients at 30 and 90-d with a pooled OR of 0.60(95%CI 0.46-0.77,P<0.01).CONCLUSION The level of ev

关键词： Acute-on-chronic liver failure Acute liver failure plasmapheresis plasma exchange Liver failure

The critical role of therapeutic plasma exchange in ABO-incompatible liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2022年第6期21卷 538-542页

作者： Cheng-Zuo Han Qiang Wei Meng-Fan Yang Li Zhuang Xiao Xu Department of Hepatobiliary and Pancreatic Surgery The Center for Integrated Oncology and Precision MedicineAffiliated Hangzhou First People’s HospitalZhejiang University School of MedicineHangzhou 310006China Institute of Organ Transplantation Zhejiang UniversityHangzhou 310003China National Center for Healthcare Quality Management in Liver Transplant Hangzhou 310003China Department of Hepatobiliary and Pancreatic Surgery Shulan(Hangzhou)HospitalHangzhou 310022China

Background:The shortage of donor liver restricts liver transplantation(LT).Nowadays,donor liver with ABO blood group incompatibility between donor and recipient has become an option to expand the source of donor *** it is now possible to perform ABO-incompatible(ABO-I)LT,antibody-mediated rejection(AMR)has been recognized as the primary cause of desperate outcomes after ABO-I ***-A/B antibody is the trigger of immune response to ABO-I LT graft *** plasma ex-change(TPE)can quickly reduce the titer of plasma antibodies and effectively inhibit humoral *** sources:We searched PubMed and CNKI databases using search terms“therapeutic plasma ex-change”,“ABO-incompatible liver transplantation”,“ABO-I LT”,“liver transplantation”,“LT”,“antibody-mediated rejection”,and“AMR”.Additional publications were identified by a manual search of references from key *** relevant publications published before September 30,2020 were included in this ***:Different centers have made different attempts on whether to use TPE,when to use TPE and how often to use ***,the control standard of lectin revision level is always controversial,the target titer varies significantly from center to center,and the standard target titer has not yet been *** has several schemes to reduce antibody titers,but there is a lack of clinical trials that provide standardized ***:TPE is essential for ABO-I ***,further research and clinical trials should be conducted to determine the best regimen for TPE to remove ABO antibodies and prevent AMR.

关键词： plasma exchange ABO blood group system Blood group incompatibility Liver transplantation Graft rejection

Successful use of plasma exchange in fulminant lupus myocarditis coexisting with pneumonia: A case report

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World Journal of Clinical Cases 2020年第10期8卷 2056-2065页

作者： Zhou-Xiong Xing Kun Yu Hang Yang Guo-Yue Liu Ni Chen Yong Wang Miao Chen Department of Critical Care Medicine Affiliated Hospital of Zunyi Medical UniversityZunyi 563000Guizhou ProvinceChina Department of Anesthesiology Affiliated Hospital of Zunyi Medical UniversityZunyi 563000Guizhou ProvinceChina

BACKGROUND Fulminant lupus myocarditis is a rare but fatal manifestation of systemic lupus *** immunosuppressive treatments are important in its successful ***,they can significantly damage the immunity and are associated with a considerable risk of infection development and *** present a rare and complicated case of a 20-year-old female diagnosed with fulminant lupus myocarditis accompanied by *** patient was successfully treated with plasma exchange(PE)for fulminant lupus *** SUMMARY A 20-year-old Chinese woman presented to the Hematology Department complaining of fatigue and knee *** test showed anemia and *** the second day of hospitalization,she was transferred to the ICU due to dyspnea and *** profiles showed hypocomplementemia and positive antinuclear *** tomography showed an enlarged heart and *** revealed an enlarged heart with a low left ventricular ejection *** lupus myocarditis with cardiogenic shock was initially *** to the accompanying pneumonia,aggressive immunosuppression was *** cardiac function remained critical after the initial therapy of intravenous immunoglobulin and corticosteroids at a conventional dose,but she responded well to later PE therapy plus corticosteroids *** patient fully recovered with normal cardiac *** This case indicates that PE is a valuable treatment choice without adverse effects of immunosuppression in patients with fulminant lupus myocarditis and coexisting infection.

关键词： plasma exchange Cardiogenic shock Lupus myocarditis Systemic lupus erythematosus Immunosuppressive treatment Case report

Double plasma Molecular Adsorption System with Sequential Low-dose plasma exchange in Patients with Hepatitis B Virus-related Acute-on-chronic Liver Failure:A Prospective Study

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Journal of Clinical and Translational Hepatology 2023年第4期11卷 908-917页

作者： Lu Wang Wenxiong Xu Shu Zhu Guoli Lin Jing Lai Yufeng Zhang Ying Liu Lihua Zheng Qiumin Luo Zhiliang Gao Chan Xie Liang Peng Second School of Clinical Medicine Binzhou Medical UniversityYantaiShandongChina Department of Infectious Diseases Third Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouGuangdongChina Key Laboratory of Tropical Disease Control(Sun Yat-sen University) Ministry of EducationGuangzhouGuangdongChina

Background and Aims:To investigate the safety and efficacy of double plasma molecular adsorption system(DPMAS)with sequential low-dose plasma exchange(LPE)in treating early hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF).Methods:Clinical data of patients with HBVACLF were prospectively collected,including patients in a DPMAS with sequential LPE(DPMAS+LPE)group and those in a standard medical treatment(SMT)*** primary endpoint was death or liver transplantation(LT)at 12 weeks of ***-score matching was performed to control the effects of confounding factors on prognosis between the two ***:After 2 weeks,total bilirubin,alanine aminotransferase,blood urea nitrogen levels,and Chinese Group on the Study of Severe Hepatitis B score,were significantly lower in the DPMAS+LPE group than those in the SMT group(p<0.05).After 4 weeks,laboratory parameters of the two groups were *** cumulative survival rate of the DPMAS+LPE group was significantly higher than that of the SMT group at 4 weeks(97.9%vs.85.4%,p=0.027),but not at 12 weeks(85.4%vs.83.3%,p=0.687).Cytokine levels were significantly lower in 12-week survival group than in the death-or-LT group(p<0.05).Functional enrichment analysis showed that downregulated cytokines were mainly involved in positive regulation of proliferation and activation of lymphocytes and monocytes,regulation of immune effect response,regulation of endotoxin response,and glial cell ***:DPMAS+LPE significantly improved the 4-week cumulative survival rate,and ameliorated the inflammatory response in ***+LPE may be a promising modality for patients with early HBV-ACLF.

关键词： plasma exchange Double plasma molecular adsorption system Acute-on-chronic liver failure Prognosis

The MELD scoring system for predicting prognosis in patients with severe hepatitis after plasma exchange treatment

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Hepatobiliary & Pancreatic Diseases International 2007年第5期6卷 492-496页

作者： Yu, Jian-Wu Wang, Gui-Qiang Zhao, Yong-Hua Sun, Li-Jie Wang, Shu-Qin Li, Shu-Chen Harbin Med Coll Dept Infect Dis Affiliated Hosp 2 Harbin 150086 Peoples R China Peking Univ First Hosp Dept Infect Dis Beijing 100034 Peoples R China

BACKGROUND: Hepatic failure caused by severe hepatitis is a clinical syndrome where the major liver functions, particularly detoxification, synthetic functions, and metabolic regulation are impaired to different degrees, and may result in major life-threatening complications such as hepatic encephalopathy, ascites, jaundice, cholestasis, bleeding and hepatorenal syndrome. plasma exchange (PE) has been found useful in treating patients with fulminant hepatic failure by removing hepatic toxins and replacement of clotting factors, so PE treatment has temporary supportive effects on liver failure caused by severe viral hepatitis. in this study, our aim was to predict the prognosis of patients with severe hepatitis after PE treatment using the end-stage liver disease (MELD) scoring system. METHODS: Two hundred and twenty patients were randomly divided into PE and control groups, and the MELD score was calculated for each patient according to the original formula. The efficacy of PE was assessed by mortality or improvement in biochemical parameters and MELD score. RESULTS: The levels of total bilirubin and international normalised ratio (INR) in patients whose MELD scores were between 30 and 39 were lower than those before PE treatment, as those in patients whose MELD scores were 40 or higher. The mortality of patients in the PE group with MELD scores from 30 to 39 was 50.0%, while it was 83.3% in the control group (P0.05). CONCLUSIONS: PE treatment can decrease the serum total bilirubin level and INR and MELD score of patients with severe hepatitis and improve liver function. Compared with the control group, PE can significantly decrease the mortality of patients with MELD scores from 30 to 39, but has no effect in patients with MELD scores of 40 or higher.

关键词： severe hepatitis model for end-stage liver disease plasma exchange mortality

Successful treatment of plasma exchange-refractory thrombotic thrombocytopenic purpura with rituximab:A case report

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World Journal of Clinical Cases 2020年第12期8卷 2617-2622页

作者： Jian Chen Jing-Xia Jin Xiao-Fei Xu Xuan-Xuan Zhang Xing-Nong Ye Jian Huang Department of Ultrasonography The Fourth Affiliated Hospital of Zhejiang University School of MedicineYiwu 322000Zhejiang ProvinceChina Department of Hematology The Fourth Affiliated Hospital of Zhejiang University School of MedicineYiwu 322000Zhejiang ProvinceChina

BACKGROUND Thrombotic thrombocytopenic purpura(TTP),a subtype of thrombotic microangiopathy,has a very high fatality rate if there is no timely diagnosis or ***,we report a case of TTP refractory to high displacement plasma exchange,which was later successfully treated with *** SUMMARY Here we report a case of refractory TTP in a 63-year-old woman with a low platelet count and decreased ADAMTS13 *** platelet count was 9×109/L,hemoglobin level was 81 g/L,and ADAMTS13 wasplasma exchange(PEX),her platelet levels were still ***,after 6 d of treatment with rituximab,her platelet count increased and ADAMTS13 activity returned to *** PEX can cure most patients,but the relapse rate can be up to 50%-60%.This case suggested that rituximab can improve the curative efficiency of PEX and prevent disease relapse in TTP.

关键词： Thrombotic thrombocytopenic purpura ADAMTS13 plasma exchange Rituximab Case report

Streptococcal pneumonia-associated hemolytic uremic syndrome treated by T-antibody-negative plasma exchange in children: Two case reports

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World Journal of Clinical Cases 2021年第27期9卷 8164-8170页

作者： Xiu-Li Wang Yue Du Cheng-Guang Zhao Yu-Bin Wu Ni Yang Liang Pei Li-Jie Wang Qiu-Shi Wang Department of Pediatrics Shengjing Hospital of China Medical UniversityShenyang 110004Liaoning ProvinceChina Department of Blood Transfusion Shengjing Hospital of China Medical UniversityShenyang 110004Liaoning ProvinceChina

BACKGROUND The occurrence of Streptococcus pneumoniae-associated hemolytic uremic syndrome(SP-HUS)is ***-Friedenreich antigen activation is highly involved in the pathogenesis of SP-HUS,and T-antibody-negative plasma exchange(PE)may be effective in the treatment of severe cases of *** SUMMARY We retrospectively reviewed two pediatric patients with *** clinical features and laboratory examination results of the children were ***-negative PE was performed in both *** children made a full recovery after repeated PE and remained well at a 2 year *** Streptococcal pneumonia continues to be an uncommon but important cause of *** successful treatment of the presented cases suggests that T-antibodynegative PE may benefit patients with SP-HUS.

关键词： Streptococcus pneumoniae Hemolytic uremic syndrome Children plasma exchange Thomsen-Friedenreich antigen exposure Case report

Retrospective Analysis of plasma exchange Combined with Glucocorticosteroids for the Treatment of Systemic Lupus Erythematosus-related Acute Pancreatitis in Central China

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2016年第4期36卷 501-508页

作者：余毅恺于飞叶丛戴玉洁黄晓伟胡绍先 Department of Rheumatology and Immunology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Department of Digestive Medicine Tongji Hospital Tongji Medical College Huazhong University of Science and Technology

Systemic lupus erythematosus-related acute pancreatitis（SLEAP） has a poor prognosis with a high mortality. We described the clinical features of SLEAP, and discussed the feasibility of plasma exchange（PE） combined with glucocorticosteroids（GC） in short-term prognosis and possible mechanism in reducing serum inflammatory cytokine IL-6 and removing serum lipids. A retrospective study was performed by an independent rheumatologist. Medical records of SLEAP from March 2010 to December 2014 were retrieved from Tongji Hospital information system, and patients were divided into two groups according to whether PE therapy was adopted. Sixteen patients treated with PE in combination with GC were classified as group A, and the other 10 patients who were treated with merely GC were classified as group B. Patients＇ clinical remission rate and average daily GC dosage after two-week therapy were compared between the two groups. Patients＇ serum inflammatory cytokines and lipid concentration were compared between baseline and after two-week treatment in both groups. Pearson correlation test was performed to determine association between serum cytokines and Ranson score. SLEDAI score in group A patients at baseline（14.8±3.1） showed no statistical difference from that in group B（14.1±3.3）. At baseline serum IL-6 levels had no significant difference between group A [13.14（11.12, 16.57） mg/L] and group B [14.63（11.37, 16.37） mg/L]; after two-week therapy IL-6 decreased significantly in group A [9.16（7.93, 10.75）mg/L] while it did not show decreasing trend in group B [13.62（9.29,17.63） mg/L]. Serum lipid concentration after two-week therapy in group A [（TC=5.02±0.53, TG=1.46±0.44） mmol/L] decreased significantly compared to baseline [（TC=6.11±0.50, TG=2.14±1.03） mmol/L], while similar tendency was not observed in group B. The remission rate after two-week therapy was higher in group A（70.0%） than in group B（25.0%）. Acute pancreatitis（AP） was one of the clinical manifestations of active S

关键词： systemic lupus erythematosus acute pancreatitis plasma exchange IL-6 serum lipid