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ACD-A에 아나필락시스를 보인 환자에서 UFH을 단독으로 사용한 혈장교환술 2례

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Author(s)
Hyein KangDo-Hoon KimDong-Seok JeonWonmok LeeNamhee RyooJungsook Ha
Publication Year
2020
Keyword
Plasma exchangeHeparinAnticoagulation
Abstract
Plasma exchange performed with the aid of acid-citrate-dextrose formula A (ACD-A) is generally regarded as safe. However, unfractionated heparin (UFH) can serve as an anticoagulant for patients experiencing serious side effects such as anaphylaxis. No guidelines have currently been defined for the stand-alone UFH dosing during plasma exchange. We describe here two patients who developed anaphylaxis to ACD-A during plasma exchange, and we successfully used UFH as a standalone anticoagulant. The first patient was a 55-year-old man who required plasma exchange before ABO-incompatible kidney transplantation. During plasma exchange, he developed an allergic reaction. Thereafter, UFH was used as a standalone anticoagulant during four sessions of plasma exchange; the UFH (5,000 units) was added to a 500 mL normal saline bag and the UFH:whole blood ratio was maintained at 1:28. The second patient was an 80-year-old woman with steroid pulse-resistant neuromyelitis optica. She developed an allergic reaction during the first session of plasma exchange. The patient subsequently underwent five successful sessions of plasma exchange using UFH as a standalone anticoagulant. These findings may be useful when establishing a protocol for UFH as a standalone anticoagulant during plasma exchange in patients who develop an allergic reaction to citrate.
Alternative Title
Two Cases of Successful Plasma Exchange with Unfractionated Heparin Anticoagulation in Patients Exhibiting Anaphylaxis to Acid-citrate-dextrose Formula A
Department
Dept. of Laboratory Medicine (진단검사의학)
Publisher
School of Medicine (의과대학)
Citation
대한수혈학회지, Vol.31(1) : 55-60, 2020
Type
Article
ISSN
2383-6881
DOI
10.17945/kjbt.2020.31.1.55
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/42701
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