Double filtration plasmapheresis in hypertriglyceridemic pancreatitis: Triglyceride levels and clinical outcomes

Hirano, Ryuichiro

doi:10.1002/jca.21865

Cited by 7 publications

(3 citation statements)

References 6 publications

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“…They showed a 74.2% reduction in TG levels after a session of DFPP, similar to our study, but no bene cial effects on clinical outcomes between the groups [26] . The reason for the negative conclusion was considered to be due to the difference in the initial TG levels [31] . In Lu's study, the mean TG levels in patients without DFPP treatment were reduced from 31.1 mmol/L (2755 mg/dL) on admission to 5.4 mmol/L (478 mg/dL) at 48 hours, with no difference from those treated with DFPP.…”

Section: Discussionmentioning

confidence: 99%

“…In Lu's study, the mean TG levels in patients without DFPP treatment were reduced from 31.1 mmol/L (2755 mg/dL) on admission to 5.4 mmol/L (478 mg/dL) at 48 hours, with no difference from those treated with DFPP. This meant that DFPP was not necessary because conservative management alone was able to reduce the TG levels su ciently with such initial TG levels [26,31] . In the subgroup of our study, we found that early DFPP treatment could reduce the risk of POF only in patients with pre-TG levels above 56.5 mmol/L (5000 mg/dL).…”

Section: Discussionmentioning

confidence: 99%

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Initiation time of double-filtration plasma apheresis affects the risk of persistent organ failure in hypertriglyceridaemia-induced acute pancreatitis: a retrospective study

Gao

Wang

et al. 2023

Preprint

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Background The effect of double filtration plasma apheresis (DFPP) on improving the outcomes of patients with hypertriglyceridaemia-induced acute pancreatitis (HTG-AP) remains unclear. The aim of this study was to evaluate the relationship between the initiation time of DFPP and the risk of persistent organ failure (POF) in an HTG-AP cohort in China. Methods We retrospectively evaluated data from HTG-AP patients treated with DFPP 48 hours after diagnosis between January 2017 and January 2022. Comparisons across tertiles of the interval from diagnosis to completion of one DFPP session (DTD) were analysed. Logistic regression models and restricted cubic splines (RCS) were used to determine the correlation between the DTD time and risk of POF. Results Of the 89 patients enrolled, 46 patients (51.69%) suffered POF in the first week of HTG-AP. DFPP was initiated at a median of 17 hours after the diagnosis was confirmed. The patients in the highest tertile of DTD time had a significantly increased prevalence of POF. After multivariate adjustment, the logistic regression models found a significant decrease in the odds ratios (OR) of POF from the highest to the lowest DTD tertile (P for trend = 0.006). Moreover, the RCS curves showed a nonlinear relationship in the adjusted OR of POF and DTD time, which remained relatively low and flat during the early DTD time but increased sharply afterwards. Conclusion Early initiation of DFPP treatment correlates with a reduced risk of POF in HTG-AP patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Initiation time of double-filtration plasma apheresis affects the risk of persistent organ failure in hypertriglyceridaemia-induced acute pancreatitis: a retrospective study

Gao

Wang

et al. 2023

Preprint

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“…This difference seems of questionable clinical significance, especially if the invasiveness, cost and lack of availability of apheresis treatment in some centers is taken into the account. However, this small difference could become significant at extremely high baseline triglycerides, e.g., above 50 mmol/L [ 54 ], as it could affect the time in which triglycerides are lowered below 10 mmol/L.…”

Section: Potential Beneficial Effects Of Tpementioning

confidence: 99%

The role of apheresis and insulin therapy in hypertriglyceridemic acute pancreatitis—a concise review

Gubensek

2023

BMC Gastroenterol

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Severe hypertriglyceridemia (HTG) is the third most common cause of acute pancreatitis (AP) and is involved in its pathogenesis. Chylomicrons increase blood viscosity and induce ischemia, while free fatty acids induce inflammation and distant organ damage. Conservative treatment options include fasting and insulin; limited evidence shows their comparable efficacy. Plasma exchange might provide more rapid lowering of triglycerides and amelioration of systemic effects of severe AP. Available data from controlled studies show only moderately faster lowering of triglycerides with apheresis (about 70% vs. 50% with conservative treatment within 24 h) and limited data from non-randomized studies show no improvement in clinical outcomes. New evidence is expected soon from ongoing large randomized trials. Until then, insulin may be used in mild HTG-AP and plasma exchange should be considered only in severe HTG-AP, especially if the decline of triglycerides with conservative treatment is slow, and in HTG-AP during pregnancy.

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Construction of novel antiplatelet modified polyethersulfone membrane and study into its blood compatibility

Lei

et al. 2022

Biomaterials Advances

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Double filtration plasmapheresis in hypertriglyceridemic pancreatitis: Triglyceride levels and clinical outcomes

Cited by 7 publications

References 6 publications

Initiation time of double-filtration plasma apheresis affects the risk of persistent organ failure in hypertriglyceridaemia-induced acute pancreatitis: a retrospective study

Initiation time of double-filtration plasma apheresis affects the risk of persistent organ failure in hypertriglyceridaemia-induced acute pancreatitis: a retrospective study

The role of apheresis and insulin therapy in hypertriglyceridemic acute pancreatitis—a concise review

Construction of novel antiplatelet modified polyethersulfone membrane and study into its blood compatibility

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