Discontinuous plasma exchange with prostaglandin I2 (5ng/kg/min) and low dosage heparin (5-6 IU/kg/min) (treatment I), and ACD solution alone (treatment II) was studied. During both treatments the activated partial thromboplastin time remained within the normal range. After treatment I platelet count was not decreased but in vitro platelet aggregation was reduced (p < 0.001). After treatment II platelet count was reduced and in vitro platelet aggregation unchanged.
Prostaglandin I2 at this dosage caused no cardiovascular complications. The physiopathological implications of these differences are discussed.
DauP.C., LindstromJ.M., CasselC.K., DenysE.M., ShewE.E., SpitlerL.E.Plasmapheresis and immunosuppressive drug therapy in myasthenia gravis.New Eng J Med1977; 297: 1134.
2.
JonesJ.V., CummingR.H., BaconP.A., EveryJ., FraserI.D., BothamleyJ., TribeC.R., DavisP., HughesG.R.V.Evidence for a therapeutic effect of plasmapheresis in patients with systemic lupus erythematosus.Quart J Med1979; 48: 555.
ChirusideA., UrbaniskS.J., ProwseC.V., KellerAjCoagulation abnormalities following intensive plasma exchange on the cell separator.Br J haemat.1981; 48: 627.
6.
SultanY., BusselA.Maisomeuve P., Ponpeney M., Sitty X, Gaydos P. Potential danger of thrombosis after plasma exchange in the treatment of patient with immune disease.Transfusion1979; 19: 588.
7.
SmithM.C., DonviriyasupK., CrowJ.W., CatoA.E., ParkG.D., HassidA., DunnM.C.Prostacyclin substitution for heparin in long-term hemodialysis.Am J Med1982; 73: 669.
8.
FlaumM.A., CuneoR.A., AppelbaumF.R., DiesserothA.B., King EngelW., GralnikH.R.The hemostatic imbalance of plasma exchange transfusion.Blood1979; 54(3): 694.
9.
UrbaniakS.J., ProwseC.V.Hemostatic changes during plasma exchange.Plasma Ther Trans Technol1983; 4: 21.
10.
ShapiraN., SchaffH.V., PiehelerJ.M., WhiteR.D., SillJ.C., PluthJ.R.Cardiovascular effects of protamine sulfate in man.J Thor Card Surg1982; 84: 505.
11.
ShumakK.H., RockG.A.Therapeutic plasma exchange.New Eng J Med1984; 310: 762.
