Therapeutic Membrane Plasmapheresis
- 1902 Heldon reinfuses separated erythrocytes into rabbits.
- 1950 Replacing breakable glass bottles with durable plastic bags allows for the evolution of a collection system capable of safe and easy preparation of multiple blood components from a single unit of whole blood.
- 1953 Development of the refrigerated centrifuge further expedites blood component therapy. Cohn developed the first blood centrifuge based on a dairy centrifuge and it was produced by the Protein foundation group.
- 1960 A. Solomon and J.L. Fahey report the first therapeutic plasmapheresis procedure, separating whole blood into plasma and red blood cells.
- 1964 Plasmapheresis is introduced as a means of collecting plasma for fractionation.
- 1972 Apheresis is used to extract one cellular component, returning the rest of the blood to the donor.
- 1978 Primary Membrane Plasma Separator introduced as a method for performing therapeutic plasma exchange.
- Early 80's First membrane PE (plasma exchanger) system to recieve FDA approval introduced as Century TPE.
- 1983 Michael J. Lysaght et al. first describe spontaneous membrane plasmapheresis.
- 1985 Thermo filtration introduced by the Malchesky group. Warming blood to 38 degrees Celsius prevents cryogel formation and poor Plasma Fractionation performance
- 1990 An improved membrane with outstanding selective permeability is patented. The membrane allowed for high albumin recovery rate, while removing a high ratio of immunoglobulins M and G.
Animal Experimentation and Early Years
Plasmapheresis began life as a procedure in animal experimentation as early as 1902. By 1914, John J. Abel et al. had described a process in which dog’s blood was centrifuged and certain components were reintroduced to the cardiovascular system. In 1931 a procedure was described where continuous plasmapheresis was run on a dog through the use of a membrane wherein the plasma and cellular components could be separated.
World War 2 and the Growth of Blood Component Therapies
Dr. Edwin J. Cohn
Before and during World War 2 the Laboratory of Physical Chemistry at Harvard Medical School founded and headed by Edwin J. Cohn was the main force in the development of blood component therapies. His laboratory was influential in both discovering the different blood proteins and their function.
Another critical advancement for the development of blood technologies was the replacement of glass bottles with durable plastic bags in the 1950s. Along with the development of a new centrifuge apparatus by Cohn’s group, the new technologies allowed for the safe collection and preparation of multiple blood components from a single unit of blood. Interestingly, Cohn based his centrifuge design on a simple dairy centrifuge.
Plasmapheresis as a Therapeutic Solution
The first therapeutic Plasmapheresis procedure was described in 1960 by A. Solomon and J.L. Fahey. In 1964 plasmapheresis was introduced as a method for plasma fractionation a field it would quickly take over.
In 1978, membrane plasmapheresis was introduced as a method for therapeutic plasma exchanges. The new technique had the advantage of less platelet loss and the potential for greatly decreasing hemolysis. In the early 1980’s the First Membrane Plasma Exchanger system was approved by the FDA and introduced as the Century TPE.
Plasmapheresis Apparatus
In 1983, Lysaght et al. first described a novel approach to membrane plasmapheresis. Termed "spontaneous membrane plasmapheresis," the simplified system eliminated the usage of pumps in the circuit, relying instead on gravity and blood pressure. Even with the elimination of the blood pumps, maximum filtration rates for spontaneous membrane plasmapheresis are approximately equal to the filtration rate for plasmapheresis using the pumps. The simplicity of this type of plasmapheresis increases cost-effectiveness.
Dr. Michael J. Lysaght
Further improvements in technology occurred in 1985 when the Malchesky group introduced thermofiltration wherein blood is warmed to 38 degrees Celsius to prevent cryogel formation and increase plasma fractionation performance.
In 1990 an improved membrane with outstanding selective permeability patented. The membrane allowed for high albumin recovery rate, while removing a high ratio of immunoglobulins M and G.
Sources:
Abel, J et al. Plasma Removal With Return of Corpuscles. J. Pharmacol. Exp. Ther. 1914; No. 5.
Geiger, A et al. Method of Ultrafiltration In Vivo. J. Phys. 1931; 71.
Lysaght, MJ et al. Spontaneous Membrane Plasmapheresis. Trans Am Soc Artif Intern Organs 1983; 29.
https://content.nejm.org/cgi/content/full/349/5/511
www.highbeam.cin/doc/1g1-41309316.html
Image Sources:
http://research.brown.edu/research/profile.php?id=1100924638
http://www.pbs.org/wnet/redgold/innovators/bio_cohn.html
http://www.blackwell-synergy.com/doi/pdf/10.1046/j.1526-0968.2000.00231.x
http://img.alibaba.com/photo/10919679/Blood_Bags.jpg
Bio 1080 (Organ Replacement) - Spring 2008
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