Lambert Catherine, Gericke Marion, Smith Richard, Hermans Cedric
Cliniques Universitaires Saint-Luc, Brussels, Belgium.
J Clin Apher. 2011;26(1):17-22. doi: 10.1002/jca.20271. Epub 2010 Nov 17.
For therapeutic plasma exchange (TPE), continuous and intermittent flow separators are known to be efficient. This study was undertaken to compare the performances of the Spectra Optia, a continuous flow centrifugal apheresis system recently developed by CaridianBCT, with the Haemonetics Multicomponents System (MCS)+ apheresis system based on intermittent flow centrifugation. The primary objective of the study was to compare the time required to exchange one total plasma volume with both separators. The secondary objectives were to determine the plasma exchange efficiency, the plasma extraction rate, the percentage of target exchange volume achieved, and the loss of cellular components. The study involved prospectively paired comparison of 16 TPE on each device performed in patients with chronic diseases treated with TPE. The time required to exchange 1 total plasma volume was 182 ± 36 minutes for MCS+ procedures and 100 ± 20 minutes for the Spectra Optia procedures (P < 0.05, all results presented as mean ± standard deviation). A significantly higher plasma extraction rate was achieved (30.2 ± 4.3 vs 16.8 ± 3.4 mL/min, respectively, P < 0.05), and the plasma exchange efficiency was slightly better with the Spectra Optia compared with the MCS+ procedures (83.4 ± 7.0 vs 80.0 ± 8.5%, P < 0.05). The platelet loss was significantly lower with the Spectra Optia compared with the MCS+ procedures (1.6 ± 2.3 vs 7.5 ± 4.2%, respectively, P < 0.05), whereas the red blood cells loss was comparable. In conclusion, the Spectra Optia has significantly higher extraction rate and exchange efficiency than the MCS+ allowing to remove the same amount of plasma in less time, by processing less blood. It also removes significantly less platelets than the MCS+ separator.
对于治疗性血浆置换(TPE),连续流和间歇流分离器都被认为是有效的。本研究旨在比较CaridianBCT公司最近开发的连续流离心单采系统Spectra Optia与基于间歇流离心的Haemonetics多成分系统(MCS)+单采系统的性能。该研究的主要目的是比较两种分离器置换一个全血浆量所需的时间。次要目的是确定血浆置换效率、血浆提取率、达到目标置换量的百分比以及细胞成分的损失。该研究前瞻性地对16例接受TPE治疗的慢性病患者在每种设备上进行的TPE进行配对比较。MCS+程序置换1个全血浆量所需的时间为182±36分钟,Spectra Optia程序为100±20分钟(P<0.05,所有结果均以平均值±标准差表示)。Spectra Optia的血浆提取率显著更高(分别为30.2±4.3 vs 16.8±3.4 mL/分钟,P<0.05),与MCS+程序相比,Spectra Optia的血浆置换效率略好(83.4±7.0 vs 80.0±8.5%,P<0.05)。与MCS+程序相比,Spectra Optia的血小板损失显著更低(分别为1.6±2.3 vs 7.5±4.2%,P<0.05),而红细胞损失相当。总之,Spectra Optia的提取率和置换效率显著高于MCS+,能够在更短的时间内通过处理更少的血液去除相同量的血浆。它去除的血小板也比MCS+分离器少得多。