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Abstract: PO0933

Can Plasma Filters Be Reused for Plasmapheresis in Resource-Poor Settings? Experience from a Tertiary Care Hospital

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Meena, Priti, All India Institute of Medical Sciences - Bhubaneswar, Bhubaneswar, Orissa, India
  • Panda, Sandip, All India Institute of Medical Sciences - Bhubaneswar, Bhubaneswar, Orissa, India
  • Mondal, Rishita, All India Institute of Medical Sciences - Bhubaneswar, Bhubaneswar, Orissa, India
  • Das, Swati, All India Institute of Medical Sciences - Bhubaneswar, Bhubaneswar, Orissa, India
Background

Therapeutic plasma exchange (TPE) is used in the management of various life-threatening illnesses. It is widely performed by nephrologists, intensivists, pathologists, or experts of transfusion medicine worldwide. However, the costs of TPE sessions are exceedingly high and it has a huge impact on patients' financial burden. Most of the patients cannot afford such a high-cost treatment. Herein, we investigated the outcomes of reuse of plasma filters in TPE for several occasions

Methods

This was an ambidirectional study that included retrospective analysis of patients receiving TPE from January 1, 2020, to December 31, 2020, whereas the patients receiving TPE from January 1, 2021, to April 30, 2021, were prospectively analysed. The procedure was performed in our hospital’s dialysis unit. Formulation of 4% peracetic acid and 24% hydrogen peroxide acid with RO water was used for reprocessing. Fresenius Plasma Flux P2 (0.6 m2) was used in the study. Clinical outcomes, risks, and cost-benefit were evaluated and compared between the plasma filter reuse group (GP-1) and no reuse group (GP-2).

Results

46 patients were included in the study. 26 patients were in the Plasma filter reuse group. 122 and 119 TPE sessions were performed in GP-1 and GP-2 respectively. A total of 58 plasma filters were used in GP-1. In six patients single plasma filter was used on 3 occasions whereas, it was used for 2 occasions in other patients. The most common indication for TPE in both groups was Guillain barre syndrome. The rates of clinical improvement in disorders for which the TPE were performed were similar in both GP-1 and GP-2 (88 % vs 90%, p=0.4). None of the patients in either group had clotting of plasma filter, any allergic reaction, or increased bleeding risk. No higher chances of sepsis were noticed in GP-1 ( P=0.08). No difference in patient survival was noticed between the two groups (97% vs 96 %, p=0.5). The cost of overall treatment was 2.5 times higher in GP-2, (P=0.003).

Conclusion

Reuse of plasma-filter is a safe and effective method for cost minimization in patients requiring TPE. This method can effectively be utilized in resource-poor settings without any increased risk of adverse effects