Removal Characteristics of Immunoglobulin G Subclasses by Conventional Plasma Exchange and Selective Plasma Exchange

• Published in: Therapeutic apheresis and dialysis 2015-08, Vol.19 (4), p.361-366
• Main Authors: Ohkubo, Atsushi, Okado, Tomokazu, Kurashima, Naoki, Maeda, Takuma, Arai, Shingo, Miyamoto, Satoko, Itagaki, Ayako, Seshima, Hiroshi, Iimori, Soichiro, Naito, Shotaro, Sohara, Eisei, Uchida, Shinichi, Rai, Tatemitsu
• Format: Article
• Language: English
• Subjects: Adult; Aged; Comparative Effectiveness Research; Female; Humans; Immune System Diseases - blood; Immune System Diseases - therapy; Immunoglobulin G - blood; Immunoglobulin G subclasses; Japan; Male; Membrane plasma separator; Membranes, Artificial; Middle Aged; Plasma Exchange - instrumentation; Plasma Exchange - methods; Plasmapheresis - instrumentation; Plasmapheresis - methods; Processed plasma volume; Removal ratio; Retrospective Studies; Selective plasma exchange; Treatment Outcome
• ISSN: 1744-9979; 1744-9987
• DOI: 10.1111/1744-9987.12346

Selective plasma exchange (SePE) using a selective membrane separator is a modified method of simple plasma exchange (PE). Immunoglobulin G (IgG) subclass distribution is one of the important immunological characteristics of IgG. However, there is little information regarding the removal characteristics of IgG subclasses by SePE and conventional PE. Here, we investigated the removal ratio of IgG subclasses by PE and SePE in seven patients with immunological disorders. When the mean processed volume was 0.88 plasma volume (PV) (corresponding to 2.12 L), the mean percent reductions by PE were as follows: IgG, 63.2%; IgG1, 64.5%; IgG2, 64.0%; IgG3, 61.4%; and IgG4, 69.5%. When the mean processed volume was 1.18 PV (corresponding to 2.98 L), the mean percent reductions by SePE were as follows: IgG, 51.6%; IgG1, 55.3%; IgG2, 52.0%; IgG3, 53.7%; and IgG4, 64.6%. In both PE and SePE, using albumin solution as the supplementary fluid, IgG was effectively eliminated regardless of IgG subclasses.