Coupled Plasma Filtration Adsorption in Patients with a History of Kidney Transplantation: Report of Two Cases

Abstract

Coupled plasma filtration adsorption (CPFA) is an extracorporeal treatment based on plasma filtration associated with an adsorbent cartridge and hemofiltration. CPFA is able to remove inflammatory mediators and it has been used to treat severe sepsis, septic shock and multiple organ dysfunction syndrome. Limited experience exists on the use of CPFA after solid organ transplantation. We report our experience with CPFA in 2 kidney transplant recipients with post-nephrolithotomy septic shock and severe unexplained rhabdomyolysis. In both the cases, excellent results were observed. In selected cases, CPFA can be safely and effectively used in patients with a solid organ transplant. However, additional studies are needed in this particular setting, to further investigate the potential role of CPFA for the treatment of other conditions associated with excessive inflammation, such as in rheumatologic disorders and delayed graft function.

The Use of Supra-Hemodiafiltration in Traumatic Rhabdomyolysis and Acute Kidney Injury: A Case Report

“…Two authors have previously described cases of rhabdomyolysis treated with a "sister system" called coupled plasma filtration adsorption (CPFA), which was improved for patients admitted to the intensive care unit. Lai et al [9] reported their experience in using CPFA in one kidney transplant recipient with severe unexplained rhabdomyolysis that partly resembles our patient. In line with our data, the authors achieved a successful decline in myoglobin and PCT by means of 5 consecutive CPFA treatments.…”

The Use of Coupled Plasma Filtration Adsorption in Traumatic Rhabdomyolysis

“…Lai et al reported the successful use of CPFA in two kidney transplant patients with post-nephrolithotomy septic shock and severe rhabdomyolysis of unknown origin [19]. …”

Early intensive treatment to prevent kidney failure in post-traumatic rhabdomyolysis: Case report

“…The use of CPFA in rhabdomyolysis resulting in kidney transplantation has been described. 23 In a limited number of cases, we have described the use of CPFA in post-traumatic rhabdomyolysis with renal damage, elevated blood levels of creatinine, and contraction or absence of diuresis. 24…”