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Semin Thromb Hemost 2009; 35(1): 076-080
DOI: 10.1055/s-0029-1214150
© Thieme Medical Publishers

Extracorporeal Immunoadsorption for the Treatment of Coagulation Inhibitors

Massimo Franchini1 , Maria Sassi1 , Paolo Dell'Anna1 , Franco Manzato2 , Gian Luca Salvagno3 , Martina Montagnana3 , Marco Zaffanello4 , Giovanni Targher5 , Giuseppe Lippi3
  • 1Immunohematology and Transfusion Center, University Hospital of Parma, Parma, Italy
  • 2Laboratory of Clinical Chemistry, City Hospital of Mantova, Mantova, Italy
  • 3Section of Clinical Chemistry, Department of Biomedical and Morphological Sciences, University of Verona, Verona, Italy
  • 4Department of Mother-Child and Biology-Genetics, University of Verona, Verona, Italy
  • 5Section of Endocrinology, Department of Biomedical and Surgical Sciences, University of Verona, Verona, Italy
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Publication History

Publication Date:
23 March 2009 (online)

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ABSTRACT

Extracorporeal immunoadsorption is a widely used technique for the removal of pathogenic antibodies in a variety of immunologic disorders. This procedure has been used in patients with high-titer inhibitors against coagulation factors for the temporary removal of antibodies before initiating replacement therapy to achieve hemostasis and stop acute bleeding or to cover a surgical procedure. Inhibitor removal by immunoadsorption has also been included at the onset of immune tolerance protocols in both acquired and congenital hemophilia. This article summarizes the current knowledge on the use of this technique in patients with inhibitors against coagulation factors. Overall, the published literature documents that extracorporeal immunoadsorption is a safe and useful technique for the elimination of coagulation inhibitors. However, further randomized clinical trials are needed to better assess the cost-effectiveness of such procedures.

KEYWORDS

Immunoadsorption - bleeding - inhibitors - hemophilia

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Massimo FranchiniM.D. 

Immunohematology and Transfusion Center, Department of Pathology and Laboratory Medicine, University Hospital of Parma

Parma, Italy

Email: massimo.franchini@azosp.vr.it

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