Naukowo potwierdzone korzyści DFPP

Study 1

Relapsing and Progressive Complications of Severe Hypertriglyceridemia: Effective Long-Term Treatment with Double Filtration Plasmapheresis

Hypertriglyceride-associated events (acute pancreatitis, progression of cardiovascular complications) in the observation period before and with DFPP; n=10).

https://pubmed.ncbi.nlm.nih.gov/32191938/ 

Significantly fewer adverse events with DFPP

Study 2

Effect of Double Filtration Plasmapheresis (DFPP) in Male Patients with Borderline Hyper-LDL-cholesterolemia : Lipid Removal and Inflammation Suppression

https://www.jstage.jst.go.jp/article/jaam/6/5/6_5_32/_article 

Results: Among physical symptoms in AAQol, “tired eyes,” “blurry eyes,” “stiff shoulders,” and “feeling of ill-health” significantly decreased after 8 weeks in the DFPP group. Hematology revealed that hemoglobin (+3.6%, p=0.047), total protein (+4.1%, p=0.019), and albumin (+4.9%, p=0.018) were maintained at higher levels after 8 weeks in the DFPP group than the control group. Despite LDL-C removal, the hepatic steatosis index ALT (+5.7%, p=0.008) and lipid metabolism index LDL-C (+11.6%, p=0.012) were apparently higher in the DFPP group. Endocrinology showed a decreasing trend of DHEA-s (−13.7%, p=0.003), increasing trend of cortisol (+27.5%, p=0.005), and increasing trend of progesterone (+50%, p=0.030) in the DFPP group compared with the control group. High-sensitivity CRP tended to decrease in the DFPP group compared with the control group (−26.5%, p=0.030). There was no significant change in PWV or ABI in the DFPP group. No serious adverse events were caused by DFPP.
Conclusion: LDL-C removal by DFPP might suppress inflammation and improve tissue environment in visceral adipose and liver tissues with fatty deposits.

 

Study 3

Double filtration plasmapheresis for children with different types of critical kidney diseases: a single-center retrospective cohort study

https://tp.amegroups.org/article/view/111550/html 

Results: Totally there were 10 children receiving 44 sessions of DFPP, including 2 males and 8 females, with a median age of 11.2 years old (5–13 years) and a median weight of 42.1 kg (20–59 kg). Five patients were treated for systemic lupus erythematosus (SLE), three patients for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), one for C3 glomerulopathy and one for ABO-incompatible renal transplantation. Plasma autoantibodies decreased substantially by 93% and 89% in those with SLE and AAV after the last session, respectively. Complete or partial responses were achieved in 80%, 33.3%, 100% and 100% of patients with SLE, AAV, C3 glomerulopathy, and ABO-incompatible renal transplantation, respectively. The proportion of cumulative IgG, fibrinogen, and albumin removal at the end of the last sessions were 58.8%, 67.69%, and 14.05% respectively. The removal of calcium, potassium and creatinine were not statistically significant. A few episodes (4.55%) of hypotension were observed when fresh frozen plasma was used as the replacement fluid, and no bleeding nor severe anaphylaxis was noted.

Conclusions: The efficacy and safety of DFPP treatment in children with SLE, AAV, C3 glomerulopathy and ABO-incompatible renal transplantation were described in the present study. DFPP is proven to be a safe apheresis method for children weighing more than 20 kg.

 

Study 4

THERAPEUTIC PLASMA EXCHANGE AND DOUBLE FILTRATION PLASMAPHERESIS IN SEVERE NEUROIMMUNE DISORDERS

https://pmc.ncbi.nlm.nih.gov/articles/PMC7314295/ 

The TPE and DFPP procedures provide first-line management in several neuroimmune disorders with severe evolution. In our study, the overall neurological improvement rate after TPE and DFPP procedures was 80%, with mild and manageable complications and without death generated directly by these procedures. The alternative treatment to TPE and DFPP is high-dose IVIG, which is easy to administer but is more expensive and difficult to obtain in our hospital. To our knowledge, this report presents the largest study group in our country in which neurological patients were treated with TPE and DFPP. These therapeutic procedures are safe and efficient, provided that they are performed by experienced practitioners, and are much less expensive than IVIG while having the same efficiency.

 

Study 5

Successful treatment of positive-sense RNA virus coinfection with autoimmune hepatitis using double filtration plasmapheresis

https://pmc.ncbi.nlm.nih.gov/articles/PMC8006769/ 

DFPP can remove viruses ranging from 40 to 300 nm in size and removes or depletes or filtrates these viruses on the membrane. These observations suggest that DFPP has potential as a novel method for the treatment of COVID-19 a disease and recently tried and is slowly making progress.

 

Study 6

Changes in Water Properties in Human Tissue after Double Filtration Plasmapheresis-A Case Study

https://www.zora.uzh.ch/id/eprint/219868/1/Scholkmann_WaterProperties_molecules_2022_Neo_USZ.pdf 

The changes in tissue water demonstrated by our case study suggest that the positive physiological effects of DFPP in general and of INUSpheresis with the TKM58 filter in particular, may be associated with improvements in water quality in blood and tissues related to the respective water molecular structures.

 

 

Study 7

https://www.sciencedirect.com/science/article/abs/pii/S0165572824001826 

Effectiveness of double-filtration plasmapheresis in reducing immunoglobulin and culprit antibody levels in neuroimmune disorders

  • Elevated culprit antibodies are crucial in triggering neurologic autoimmune disorders, causing symptoms like memory loss, behavioral issues, seizures, psychosis, and movement disorders.
  • DFPP is increasingly used in clinics for its semiselective removal of pathogenic substances like criminal antibodies without added plasma.
  • DFPP combined with corticosteroids or nonsteroidal immunosuppressants improves outcomes in neurologic autoimmune diseases.

 

Study 8

Plasma exchange: An effective method to eliminate neurotoxic lipophilic chemicals from blood

https://pmc.ncbi.nlm.nih.gov/articles/PMC10087461/ 

The Alzheimer's Management by Albumin Replacement (AMBAR) trial demonstrated the clinical efficacy of plasma exchange (PE) with albumin replacement for slowing the progression of disease in patients with mild‐to‐moderate Alzheimer's disease. 

 

Study 9

Double Filtration Plasmapheresis Treatment of Refractory Multiple Sclerosis

https://www.researchgate.net/publication/346362062_Double_Filtration_Plasmapheresis_Treatment_of_Refractory_Multiple_Sclerosis_Relapsed_on_Fingolimod_A_Case_Report 

With regards to the paraclinical aspects of this case, the expected clinical improvement after DFPP cycles was associated with whole brain atrophy as detected in MRI post-analysis by Siena calculations. This phenomenon was consistent with a strong anti-inflammatory effect of DFPP on the nervous tissue, resulting in reduction of edema rather than tissue components, after the removal of humoral inflammatory elements from the blood.
Study 10

Comparison of double-filtration plasmapheresis (DFPP) versus heparin-mediated extracorporeal LDL-precipitation (HELP)-apheresis in early-onset preeclampsia

https://pubmed.ncbi.nlm.nih.gov/38728925/

Conclusions: DFPP proved to be save and pregnancies remained stable as long as 19 days. Although babies were born very preterm both babies could finally be dismissed from hospital. No relevant clinical differences between DFPP and HELP-apheresis could be observed. Therefore, DFPP may extend the range of available apheresis techniques to prolong pregnancies in early-onset preeclampsia. However, further studies are necessary to gain more information. 

Study 11

Double filtration plasmapheresis for pregnancy with hyperlipidemia in glycogen storage disease type Ia: A case report

https://www.wjgnet.com/2307-8960/full/v10/i28/10273.htm 

In summary, we described a case of a woman who was having GSDIa but had been misdiagnosed as a patient with a recurrent seizure only for 22 years. During her pregnancy, she developed anemia and extremely high hyperlipidemia. After DFPP lipid-lowering treatment and genetic testing, the patient was accurately diagnosed and eventually gave birth to a healthy baby.

 

Study 12

Case report: Double filtration plasmapheresis (DFPP) for severe rhesus-D alloimmunization in two pregnant patients

https://pubmed.ncbi.nlm.nih.gov/37114005/

Maternal erythrocyte alloimmunization is one of the most important causes of fetal anemia. The standard treatment for anemic fetuses is intrauterine blood transfusion (IUT). However, IUT may have adverse effects, particularly before 20 weeks of gestation. In this report, two women who had previously had severely affected alloimmunized pregnancy developed high titers of anti-D antibodies before 20 weeks of gestation. To prolong pregnancy to a gestation in which intravascular IUT was possible, we used repeated double filtration plasmapheresis (DFPP) as a rescue therapy. The titers of IgG-D, IgG-A, and IgG-B decreased after DFPP treatment.....The favorable results of the two patients indicate that DFPP may be an effective and safe treatment modality for RhD immunity in pregnant women. Moreover, DFPP is potentially helpful for reducing the occurrence of ABO hemolytic disease in neonates due to the clearance of IgG-A and IgG-B antibodies (e.g., O pregnant women harbored A/B/AB neonates). However, more clinical trials are needed to verify the results.