Two apheresis systems (COBE Spectra and Fenwal CS-3000 Plus with TNX-6 chamber [CS-3000 Plus]) were compared by using their yield predictors and maximum processing times in regard to platelet yields and processing times (n = 200 each). Platelet yields (n = 50 each) and white cell (WBC) content (n = 20 each) from procedures using the current software revision (3.6) on the Spectra and various interface offset (IO) settings on the CS-3000 Plus were also compared. Significantly higher median platelet yields (4.88 [range, 1.84-9.97] vs. 4.57 [range, 2.82-9.20] x 10(11) platelets) and frequency of components with > or = 6.0 x 10(11) platelets (31.5 vs. 21.5%) were found with the Spectra. In the study with Spectra and the CS-3000 Plus IO settings, IO-10 and IO-13, overall, produced the most platelets, although the differences were not significant. All Spectra collections tested had < 5 x 10(8) WBCs, and, depending on the software revision, had either 85 percent (revision 3.6) or 100 percent (revision 2.5) of components with < 5 x 10(6) WBCs. To ensure that 100 percent of components contained < 5 x 10(8) WBCs when the CS-3000 Plus was used, IO settings of 10 or less were required, and to ensure components with < 5 x 10(6) WBCs, only IO-6 could be used. Spectra and CS-3000 Plus were capable of collecting large doses of platelets (up to the equivalent of 18 units) in processing times of 67 to 100 minutes with < 5 x 10(6) WBCs.

Patients with severe, inoperable cholestasis and intractable pruritus not responding to conventional medical therapy might benefit from a depletion of their bile acid pool by sorbent perfusion since accumulated bile acids are possible responsible for their itching. In vitro, USP-charcoal-coated glass beads removed bile acids from human plasma far better than any other sorbent tested. In order to demonstrate the safety and efficacy and charcoal plasmaperfusion in vivo, five dogs underwent plasmapheresis one week following cholecystectomy and bile duct ligation, and 2.2 +/- 0.2 (mean +/- SD) times their plasma volume was passed over a column containing 400 ml of charcoal-coated glass beads prior to reinfusion. During the procedure the plasma bile acid concentration was reduced by 40.2 +/- 4.0% and the bilirubin level by 48.2 +/- 3.3%. The columns, whose capacity was far from being saturated, retained 1.3 +/- 0.4 times the pre-perfusion plasma pool of bile acids (1.1 +/- 0.2 for bilirubin) suggesting that substantial amounts of bile acids and bilirubin were mobilized from tissue stores. The procedure was well tolerated by the animals and might have promising clinical applications.

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