Abstract
Three patients with bleeding tendency or hyperlipidemia were treated by plasmapheresis using nafamostat mesilate (FUT-175, Torii & Co., Ltd., Japan) as an anticoagulant. Double-filtration plasmapheresis (DFPP) was performed in two patients with bleeding tendency. Another patient with type V hyperlipoproteinemia was treated by centrifugation and filtration plasmapheresis (CFPP), using a centrifuge-type blood cell separator as the plasma separator and hollow fibers as the filter. The celite-activated coagulation time was measured to determine the infusion volume of FUT-175.
In patients with bleeding tendency, when FUT-175 was infused continuously at the rate of 20mg per hour, DFPP could be maintained without coagulation in the circuit and without worsening on the bleeding tendency. On the other hand, in the patient with type V hyperlipoproteinemia, because the extracorporeal circulation time for CFPP was longer than that of DFPP, FUT-175 was to be infused at a rate of at least 50 to 60mg/h. Unlike heparin, FUT-175 did not cause any change in the electrophoretic mobility of β-lipoprotein by agarose gel electrophoresis. The result suggested that FUT-175 did not affect lipid metabolism. No adverse effects were observed with the administration of FUT-175.
In conclusion, FUT-175 was useful and safe as an anticoagulant in the plasmapheresis of patients with bleeding tendency or hyperlipidemia.
