Comparison of plasma exchange procedures using three apheresis systems.

BackgroundA new protocol for the Amicus separator (Fresenius Kabi) enables the device to perform plasma exchange (PE). The aim of the study was to compare retrospectively the plasma removal efficiency (PRE) of the Amicus, the Optia (TerumoBCT), and the Spectra (TerumoBCT) when performing PEs. Study Design and MethodsWe retrospectively reviewed patients who received at least one PE with the Amicus and at least one PE with the Optia, the Spectra, or both. We collected data regarding PRE, volume of anticoagulant and calcium-magnesium (Ca-Mg) solution infused, and changes in laboratory data from patients' blood sampled immediately before starting and immediately after finishing each PE procedure: complete blood count, coagulation, acid-base equilibrium, and biochemistry variables. We also collected severe adverse events (AEs). ResultsWe performed 18, 44, and 14 PEs with the Amicus, Optia, and Spectra, respectively. We observed significant differences among the Amicus, Optia, and Spectra regarding PRE (79.88.2, 82.9 +/- 5.8, and 70.4 +/- 8.2%; p<0.001), volume of anticoagulant infused (542 +/- 196, 687 +/- 120, and 647 +/- 111mL; p=0.002), volume of Ca-Mg solution infused (81 +/- 28, 56 +/- 16, and 63 +/- 15mL; p<0.001), absolute change of ionic Ca (-0.04 +/- 0.13, -0.05 +/- 0.12, and -0.19 +/- 0.16mmol/L; p=0.002), and absolute change of Na (1.18 +/- 1.97, 1.02 +/- 1.93, and 3.71 +/- 1.98mEq/L; p<0.001). We observed no significant differences in other analytic variables and we observed no severe AEs. ConclusionThe Amicus device could effectively perform PE procedures. In terms of PRE, the Amicus and Optia were similar, but both devices were superior to the Spectra. The Amicus used a lower volume of anticoagulant when compared with the Optia.