Hemolysis in membrane plasma separators: is it caused by
filter or user?
(Sep) 20:975 1996
This is an editorial by Dr. Nose in response to data presented at ASAIO 1996
where problems of hemolysis during use of membrane-based plasmapheresis were
raised by US based apheresis experts. With use of centrifugal systems this
problem was not found.
Dr. Nose notes that membrane apheresis is widely used in Japan without such
problems, and points out that one needs to keep transmembrane pressure as low
as possible, preferably below 50 mm Hg. Higher TMP will result in
destruction of red cells. According to Dr. Nose, in Japan dedicated membrane
-based apheresis systems prevent this problem via a TMP monitoring system,
whereas in the US ordinary dialysis machines (which do not restrict the
maximum TMP) are often used for this purpose. Dr. Nose also suggests that
use of high TMP in membrane based apheresis will not increase the plasma
separation rate due to membrane pores becoming occluded with the cellular
elements of blood.
Comment: No references are provided, but this is obviously an
important issue. Comments by practicioners using membrane-based apheresis in
the US are invited. (John T. Daugirdas MD, University of Illinois at