Erythrocyte‐exchange with the OPTIA™ cell separator in patients with sickle‐cell disease

Abstract

Erythrocyte-exchange (EEX) has proven to be a very useful tool in sickle-cell disease (SCD) patients either during acute painful crisis unresponsive to hydration and/or analgesia or as a prophylactic treatment in high risk patients in those who do not tolerate hydroxyurea (HU), with the aim of lowering HbS levels. EEX may be performed either by using continuous- or discontinuous flow devices, the former being of choice in children or in low-weight patients. Thus, a low extracorporeal blood volume (EBV) could allow for a better and safer procedure management. In this study we compared EEX procedure performed with the recently released OPTIA device with EEX procedures performed using the COBE Spectra device (EBV 185 vs 270 mL, respectively). Twenty-one EEX (4 as emergency treatment) were performed in 12 patients with the Spectra device and 25 (9 as emergency treatment) in 15 patients with the OPTIA device. All the procedures were well tolerated and uneventful. We did not observe significant differences between the two devices as to pre- and post-EEX parameters, namely in target hematocrit and in HbS reduction. Noteworthy, due to the lowest EBV allowed by the OPTIA device, an EEX procedure performed in a 13 Kg- child did not require a preliminary priming of the circuit. In conclusion, the OPTIA device proved to be as effective as the Spectra device in treating SCD patients either during sickling crisis or as prophylactic therapy. The OPTIA device can be safely used in the pediatric setting since it allows a lower EBV.

The evaluation of a new apheresis device for automated red blood cell exchange procedures in patients with sickle cell disease

“…Our results are consistent with those recently reported by Perseghin and colleagues . These authors compared RBCX procedures performed with the SO to those performed with the precedent, CS, device.…”

“…Our results are consistent with those recently reported by Perseghin and colleagues. 22 These authors compared RBCX procedures performed with the SO to those performed with the precedent, CS, device. They found that the two devices were comparable in achieving the programmed target postprocedure Hct and that the lower extracorporeal volume of the SO, 185 mL compared with 270 mL for the CS, allowed RBCX procedures to be done on low-weight patients without the need for preliminary priming of the circuit.…”

Automatic depletion with Spectra Optia allows a safe 16% reduction of red blood cell pack consumption in exchanged sickle cell anemia patients

“…Several studies have described the performances of the SO device when using the RBCX technique associated (SO/DE) or not (SO) with the depletion step for patients with SCA. [13][14][15][16][17][18] These studies showed similar performance of SO compared to CSP both associated and not associated with DE. However, the number of RBCPs saved when using SO/DE has not been accurately evaluated since previous studies focused mainly on the performance and safety of the SO/DE technique.…”

“…Several studies have described the performances of the SO device when using the RBCX technique associated (SO/DE) or not (SO) with the depletion step for patients with SCA . These studies showed similar performance of SO compared to CSP both associated and not associated with DE.…”

Iron depletion with a novel apheresis system in patients with hemochromatosis

“…A new apheresis system, the Spectra Optia (Terumo BCT, Lakewood, CO) has been recently introduced in the clinical setting. So far, studies about this new apheresis device report on mononuclear cell collection, on plasma‐exchange procedures, and on RBC exchange, respectively …”