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The authors report a case of severe hypertriglyceridemia (148.5 mmol/l) in a 27-year-old woman admitted for coma of unknown origin. Initial investigations revealed ketoacidosis, pancreatitis and noncardiogenic pulmonary edema. The diabetes was unknown. Ketoacidosis was rapidly controlled. The hypertriglyceridemia was corrected by one course of plasma exchange (4,400 ml) during which the patient returned to consciousness. The patient recovered without any sequelae. Only 2 similar cases, treated by plasma exchange, have been reported in the literature until now.

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Donor safety and high-quality plasma are important assumptions for a successful plasma donation. The manual technique has two major inconveniences: It is time consuming and there are risks in the transfusion because the system is not closed. Among the available technological options, filtration has great future prospects insofar as a hemocompatible and efficient membrane can be made available and at low cost. Hemascience Travenol developed the polycarbonate membrane for the first disposable. Because of a high rate of no or very low plasma flow (5-10%), the company equipped the disposable with a new membrane: the nylon membrane. This membrane was tested according to biological and technical protocols; 39 disposables were used. The anticoagulant was acid citrate dextrose formula A. The results were good: time to collect 600 g of plasma, 34 min (only two occurrences of low flow); no problem with blocking or clotting. The main biological data show no problem with molecule activation (complement factors, coagulation factors), a good recovery of Factor VIII, and no contamination of platelets (5 +/- 2 X 10(3)/ml). No side-effects in the donor were noted. These results confirm that the Hemascience Travenol system is one of the best automatic plasmapheresis systems and could be used to separate great quantities of plasma from donors.

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