HDCN Article Review/Hyperlink

Nose Y

Hemolysis in membrane plasma separators: is it caused by filter or user?

Artif Organs (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 Chicago, IL)