Reduction in bradykinin generation during leukocytapheresis using novel cellsorba^TM CS‐180S: Effects of changing the filling solution

Abstract

We evaluated the bradykinin generation level during leukocytapheresis (LCAP) using novel Cellsorba(TM) CS-180S, which has sodium pyrosulfite and sodium carbonate as a filling solution. Subjects of this study were 14 rheumatoid arthritis patients. Regardless of the type of anticoagulant used, bradykinin levels were lower with the novel CS-180S than with the conventional CS-180S (28.7 ± 53.3 vs. 8.0 ± 2.7 as the mean ± standard deviation). When anticoagulants other than nafamostat mesilate were used with the conventional CS-180S, bradykinin levels increased at the column outlet compared with the column inlet, and adverse effects of bradykinin were seen in several cases. In contrast, bradykinin levels remained low and no bradykinin-associated adverse events were observed with the novel CS-180S. We recommend using the novel column instead of the conventional column in the treatment of LCAP.

Safety and Tolerability of Nafamostat Mesilate and Heparin as Anticoagulants in Leukocytapheresis for Ulcerative Colitis: Post Hoc Analysis of a Large‐Scale, Prospective, Observational Study

“…However, after that, in 2008, the filling solution for Cellsorba column was changed from injection water to sodium pyrosulfite and sodium carbonate. Yamada et al reported that in the Cellsorba column with new filling solution, bradykinin production was suppressed when heparin was used; no bradykinin‐associated ARs were noted. They also reported that the new filling solution may have reduced the amount of negative charge on the nonwoven polyester fiber in the Cellsorba column.…”

“…In the present study, there was no statistically significant difference in the incidence of intrafilter pressure increases between the nafamostat mesilate and heparin groups. Yamada et al reported that factor XII, which is activated by negative charge and related to blood coagulation, may be less generated in the Cellsorba column with the new filling solution. This result supports the findings of our study.…”

Removal Characteristics of Immunoadsorption with the Tryptophan‐Immobilized Column Using Conventional and Selective Plasma Separators in the Treatment of Myasthenia Gravis

“…IM‐TR has negatively charged column and filters, and thus, the risk of bradykinin production is high . Bradykinin production could induce adverse events such as hypotension, and the most common complications during IA are bradykinin‐induced hypotension and decreased fibrinogen .…”