Ponikvar Rafael, Gubenšek Jakob, Ponikvar Jadranka Buturović
Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Ther Apher Dial. 2016 Jun;20(3):246-50. doi: 10.1111/1744-9987.12431.
In 1996 we performed tandem membrane plasma exchange-hemodialysis in a 3-year-old girl and tandem immunoadsorption-hemodialysis with citrate as the only anticoagulant in a patient with Goodpasture's syndrome. In the present study, we evaluated the feasibility, efficacy and safety of 24 tandem plasma exchange/immunoadsorption hemodialysis procedures in four different circuit setups with citrate as the only anticoagulant. In two setups, the tandem procedures were connected in series (plasma exchange hemodialysis and immunoadsorption hemodialysis), while in the other two setups they were in parallel (plasma exchange hemodialysis with independent blood circuits and plasma exchange hemodialysis with independent arterial blood lines, but with a common return line). All tandem procedures were feasible, efficient and safe. No serious side-effects were recorded. The most elegant setup was the procedure with independent, parallel blood circuits. However, serial tandem procedures provided for the elimination of citrate and normalization of electrolytes before blood was returned to the patient.
1996年，我们对一名3岁女孩进行了串联膜血浆置换 - 血液透析，并对一名患有古德帕斯丘综合征的患者进行了以柠檬酸盐作为唯一抗凝剂的串联免疫吸附 - 血液透析。在本研究中，我们评估了在四种不同的回路设置中，以柠檬酸盐作为唯一抗凝剂进行24次串联血浆置换/免疫吸附血液透析程序的可行性、有效性和安全性。在两种设置中，串联程序是串联连接的（血浆置换血液透析和免疫吸附血液透析），而在另外两种设置中它们是并联的（具有独立血路的血浆置换血液透析和具有独立动脉血路但共用回血路的血浆置换血液透析）。所有串联程序都是可行、有效且安全的。未记录到严重的副作用。最理想的设置是具有独立并联血路的程序。然而，串联程序能够在血液回输给患者之前消除柠檬酸盐并使电解质正常化。
