GMA Apheresis time
A minimum of 60 minutes of apheresis at 30 ml/min or processing at least 1800cc of blood is always recommended, although there are evidence supporting higher efficacy and no safety concern obtained by processing larger volumes of blood (90 or more min)1,2
Also the intensive regimen (2 sessions/week) showed higher rate of clinical remission and a significantly shorter time to remission (14.9 ± 9.5 vs 28.1 ± 16.9 days; P < 0.0001) significantly reducing the patients' morbidity time without increasing the incidence of side effects.3
In patients weighing >100kg, apheresis time should be assessed on an individual basis.
TARGET100% PROCESSED VOLEMIA*
TARGET75% PROCESSED VOLEMIA*
TARGET50% PROCESSED VOLEMIA*
* Estimation of volemia by the Kaplan formula
1 Yoshimura N, Tadami T, Kawaguchi T, Sako et al. : Processed blood volume impacts clinical efficacy in patients with ulcerative colitis undergoing adsorptive depletion of myeloid lineage leucocytes. J Gastroenterol. 2012 Jan;47(1):49-55. doi: 10.1007/s00535-011-0464-0. Epub 2011 Sep 14. PMID: 21915624
2 Kikuyama R, Fukunaga K, Kawai M, et al.: Relevance of the processed blood volume per granulocyte and monocyte apheresis session to its clinical efficacy in patients with ulcerative colitis. Ther Apher Dial. 2011 Aug;15(4):360-6. doi: 10.1111/j.1744-9987.2011.00968.x. PM3 ID: 21884470.
3 Sakuraba A, Motoya S, Watanabe K, et al.: An open-label prospective randomized multicenter study shows very rapid remission of ulcerative colitis by intensive granulocyte and monocyte adsorptive apheresis as compared with routine weekly treatment. Am J Gastroenterol. 2009;104:2990–2995.
4 Nadler SB, Hidalgo JH, Bloch T. Prediction of blood volume in normal human adults. Surgery.1962; 51(2):224-32
Useful link to calculate pediatric blood volume:
Processed BV for apheresis in children should not be below 1.333ml to avoid hemorrhagic shock.
+10-15% margin so:
1.333ml +10%= 1.466 (>= 19,5kg) +200ml fuera=1.666 (>22,3 kg)
1.333ml +15%=1.533 (>=20,5kg) +200ml fuera=1.733 (>23,3 Kg)
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