Apheresis and Dialysis Center, School of Medicine, Keio University, Tokyo, Japan.
Department of Urology, School of Medicine, Keio University, Tokyo, Japan.
J Clin Apher. 2020 Jun;35(3):172-177. doi: 10.1002/jca.21774. Epub 2020 Mar 6.
Plasma exchange (PE) is performed for patients with autoimmune blistering diseases by using multiple vascular access routes. We retrospectively examined the safety and the efficacy of PE using direct femoral vein puncture (FVP) technique, by comparing with that using double-lumen catheter (DLC). The troubles related to vascular route, such as catheter occlusion, insufficient blood flow and hematoma, were not different between the FVP group (4.6%) and the DLC group (6.7%), whereas access-related infections occurred more frequently in the DLC group (6.7%) than the FVP group (0.4%). Regarding the efficacy, the removal rate of autoantibodies in PE using the FVP technique was similar or lower, as compared with that using the DLC. These results suggest that PE with the FVP technique is able to be performed safely in patients with autoimmune blistering diseases, although the removal of autoantibodies is not superior to that using the DLC.
血浆置换（PE）通过使用多个血管通路为自身免疫性水疱病患者进行。我们回顾性地检查了直接股静脉穿刺（FVP）技术与双腔导管（DLC）相比进行 PE 的安全性和疗效。FVP 组（4.6%）与 DLC 组（6.7%）之间血管通路相关的问题，如导管阻塞、血流不足和血肿，没有差异，但 DLC 组（6.7%）的与通路相关的感染比 FVP 组（0.4%）更常见。关于疗效，与 DLC 相比，使用 FVP 技术进行的 PE 清除自身抗体的效果相似或更低。这些结果表明，尽管使用 DLC 清除自身抗体的效果并不优于 FVP 技术，但 FVP 技术在治疗自身免疫性水疱病患者时可以安全进行。
