Passalacqua S, Staffolani E, Aureli F, Ferraro P M
Nefrologia e Dialisi, Complesso Integrato Columbus, Programma Renale UCSC, Roma, Italy.
G Ital Nefrol. 2009 Jan-Feb;26(1):81-9.
There is currently no consensus about the indications for therapeutic apheresis, also due to the lack of large clinical trials. A registry where all the data can be organized and analyzed therefore becomes a priority for all professionals involved in apheresis. The Apheresis Study Group of the Italian Society of Nephrology has instituted a registry for data collection. This report describes data collected from 1994 to 2008 by 68 units of different specialties in 15 Italian regions. Data about 29,260 treatments on 2,503 patients were recorded. Plasma exchange accounted for 43.4% of the procedures; 37% of these were performed by filtration. Plasma treatment was used in 48% of procedures, in particular with protein A immunoadsorption (11%), LDL-cholesterol apheresis by dextran sulfate adsorption (13%), and semiselective cascade or double filtration (12.5%). Cell apheresis, limited to photopheresis and leukocytapheresis, was used in 3.6% of cases, and whole blood treatment, with different techniques, in 5% of cases for the treatment of dyslipidemia, liver failure and sepsis. These procedures account for about 20% of the estimated therapeutic apheresis performed in Italy according to the national survey performed for the year 2005 by the Italian Apheresis and Cell Manipulation Society. The data collected are sufficiently informative to show a definite trend to use plasma/whole blood treatments as often as possible. The registry not only is a tool for consultation and information, but also a platform to plan and realize interdisciplinary and multicenter clinical trials.
目前对于治疗性血液成分单采的适应证尚无共识，这也是由于缺乏大型临床试验所致。因此，一个能够整理和分析所有数据的登记系统成为了所有从事血液成分单采的专业人员的首要任务。意大利肾脏病学会血液成分单采研究组已经设立了一个数据收集登记系统。本报告描述了1994年至2008年期间意大利15个地区68个不同专业科室收集的数据。记录了2503例患者接受的29260次治疗的数据。血浆置换占操作的43.4%；其中37%通过滤过进行。血浆治疗用于48%的操作，特别是蛋白A免疫吸附（11%）、硫酸葡聚糖吸附法进行的低密度脂蛋白胆固醇血液成分单采（13%）以及半选择性级联或双重滤过（12.5%）。细胞成分单采仅限于光化学疗法和白细胞去除术，用于3.6%的病例，全血治疗采用不同技术，用于5%的病例以治疗血脂异常、肝衰竭和败血症。根据意大利血液成分单采与细胞处理学会2005年进行的全国性调查，这些操作约占意大利估计的治疗性血液成分单采的20%。所收集的数据具有足够的信息量，显示出尽可能频繁使用血浆/全血治疗的明确趋势。该登记系统不仅是一个咨询和信息工具，也是规划和开展跨学科和多中心临床试验的平台。
