terapeutisk-aferese (LH Indholdsside)

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      <HtmlField Name="PageContent"><![CDATA[<h2>Basisoplysninger<a href=" " data-type="journal-reference" data-value="Cervantes CE, Bloch EM, Sperati CJ, Therapeutic Plasma Exchange: Core Curriculum 2023. Am J Kidney Dis 2023;81: 475-492" data-value-piped="Cervantes CE, Bloch EM, Sperati CJ|Therapeutic Plasma Exchange: Core Curriculum 2023.|Am J Kidney Dis|2023|81|475-492|36775691" data-url="reference-link" data-pubmedid="36775691" title="Cervantes CE, Bloch EM, Sperati CJ, Therapeutic Plasma Exchange: Core Curriculum 2023. Am J Kidney Dis 2023;81: 475-492"><sup>1</sup></a><sup>,</sup><a href=" " data-type="journal-reference" data-value="Szczepiorkowski ZM, Indications for therapeutic apheresis in hematological disorders. Semin Hematol 2020;57: 57-64" data-value-piped="Szczepiorkowski ZM|Indications for therapeutic apheresis in hematological disorders.|Semin Hematol|2020|57|57-64|32892844" data-url="reference-link" data-pubmedid="32892844" title="Szczepiorkowski ZM, Indications for therapeutic apheresis in hematological disorders. Semin Hematol 2020;57: 57-64"><sup>2</sup></a></h2>
<ul>
    <li>Aferese stammer fra gr&aelig;sk og betyder at fjerne eller tage bort. Det er et samlebegreb for ekstrakorporal h&aring;ndtering af blod fra en patient eller bloddonor for at adskille blodceller og plasma<a href=" " data-type="journal-reference" data-value="Connelly-Smith L, Alquist CR, Aqui NA, Hofmann JC, Klingel R, Onwuemene OA, Patriquin CJ, Pham HP, Sanchez AP, Schneiderman J, Witt V, Zantek ND, Dunbar NM, Guidelines on the Use of Therapeutic Apheresis in Clinical Practice - Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Ninth Special Issue. J Clin Apher 2023;38: 77-278" data-value-piped="Connelly-Smith L, Alquist CR, Aqui NA, Hofmann JC, Klingel R, Onwuemene OA, Patriquin CJ, Pham HP, Sanchez AP, Schneiderman J, Witt V, Zantek ND, Dunbar NM|Guidelines on the Use of Therapeutic Apheresis in Clinical Practice - Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Ninth Special Issue.|J Clin Apher|2023|38|77-278|37017433" data-url="reference-link" data-pubmedid="37017433" title="Connelly-Smith L, Alquist CR, Aqui NA, Hofmann JC, Klingel R, Onwuemene OA, Patriquin CJ, Pham HP, Sanchez AP, Schneiderman J, Witt V, Zantek ND, Dunbar NM, Guidelines on the Use of Therapeutic Apheresis in Clinical Practice - Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Ninth Special Issue. J Clin Apher 2023;38: 77-278"><sup>3</sup></a></li>
    <li>Teknikkerne bruges ved
    <ul>
        <li>Fremstilling af blodkomponenter og celleprodukter fra donorer </li>
        <li>Behandling af specifikke sygdomme hos patienter</li>
    </ul>
    </li>
</ul>
<h3>Terapeutisk aferese</h3>
<ul>
    <li>Terapeutisk aferese kan inddeles i tre hovedkategorier:
    <ul>
        <li>Plasmaudskiftning (plasmaferese) </li>
        <li>Plasmamodulation </li>
        <li>Cytaferese</li>
    </ul>
    </li>
    <li>Plasmaudskiftning
    <ul>
        <li>Fjernelse af patientens plasma, hvor plasmavolumen erstattes med&nbsp;bloddonorplasma eller anden substitutionsv&aelig;ske</li>
    </ul>
    </li>
    <li>Plasmamodulation
    <ul>
        <li>Ekstrakorporal selektiv fjernelse af skadelige substanser&nbsp;f.eks. antistoffer fra plasma, f&oslash;r det tilbagef&oslash;res til patienten</li>
    </ul>
    </li>
    <li>Cytaferese
    <ul>
        <li>Samling og fjernelse af blodceller f&oslash;r eventuel tilbagef&oslash;rsel til patienten </li>
        <li>Specialtilf&aelig;lde:
        <ul>
            <li>Ved fotoferese&nbsp;eksponeres perifere mononukle&aelig;re celler for UVA str&aring;ling og 8-methoxypsoralen (fotosensitivt medikament)</li>
        </ul>
        </li>
    </ul>
    </li>
</ul>
<h4>H&oslash;st af stamceller&nbsp;(dette er ikke terapeutisk aferese)</h4>
<ul>
    <li>H&aelig;matopoietiske stamceller h&oslash;stes enten fra perifert blod med celleseparator (leukaferese) eller udtages fra knoglemarv </li>
    <li>Man skelner mellem autolog og allogen stamcelle h&oslash;st, hvor der h&oslash;stes stamceller henholdsvis fra patienten selv eller en donor </li>
    <li>Celleseparatorer kan bruges til at opkoncentrere stamcellekoncentrationen i knoglemarvstransplantater</li>
</ul>
<h2>Anvendelse</h2>
<ul>
    <li>Blodbanker, dialyseafdelinger og enkelte specialinstitutioner bruger de samme teknikker til forskellige form&aring;l </li>
    <li>AABB - Association for the Advancement of Blood &amp; Biotherapies har udarbejdet guidelines for aferesebehandling ved forskellige kliniske indikationer<a href="https://www.aabb.org/aabb-store/product/apheresis-principles-and-practice-4th-edition-volume-1-therapeutic-apheresis---digital-15132798" data-type="other-reference" data-value="AABB - Association for the Advancement of Blood &amp; Biotherapies.
    APHERESIS PRINCIPLES AND PRACTICE 4TH EDITION, VOLUME 1: THERAPEUTIC APHERESIS.  AABB Press, 2020, digital, 234 pages " data-url="https://www.aabb.org/aabb-store/product/apheresis-principles-and-practice-4th-edition-volume-1-therapeutic-apheresis---digital-15132798" title="AABB - Association for the Advancement of Blood &amp; Biotherapies.
    APHERESIS PRINCIPLES AND PRACTICE 4TH EDITION, VOLUME 1: THERAPEUTIC APHERESIS.  AABB Press, 2020, digital, 234 pages "><sup>4</sup></a></li>
</ul>
<h2>Aktuelle indikationer</h2>
<h3>Hyppigste indikationer<a href=" " data-type="journal-reference" data-value="Connelly-Smith L, Alquist CR, Aqui NA, Hofmann JC, Klingel R, Onwuemene OA, Patriquin CJ, Pham HP, Sanchez AP, Schneiderman J, Witt V, Zantek ND, Dunbar NM, Guidelines on the Use of Therapeutic Apheresis in Clinical Practice - Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Ninth Special Issue. J Clin Apher 2023;38: 77-278" data-value-piped="Connelly-Smith L, Alquist CR, Aqui NA, Hofmann JC, Klingel R, Onwuemene OA, Patriquin CJ, Pham HP, Sanchez AP, Schneiderman J, Witt V, Zantek ND, Dunbar NM|Guidelines on the Use of Therapeutic Apheresis in Clinical Practice - Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Ninth Special Issue.|J Clin Apher|2023|38|77-278|37017433" data-url="reference-link" data-pubmedid="37017433" title="Connelly-Smith L, Alquist CR, Aqui NA, Hofmann JC, Klingel R, Onwuemene OA, Patriquin CJ, Pham HP, Sanchez AP, Schneiderman J, Witt V, Zantek ND, Dunbar NM, Guidelines on the Use of Therapeutic Apheresis in Clinical Practice - Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Ninth Special Issue. J Clin Apher 2023;38: 77-278"><sup>3</sup></a></h3>
<ul>
    <li>Plasmaudskiftning
    <ul>
        <li>De hyppigste indikationer:
        <ul>
            <li><a href="~/link.aspx?_id=EEAE723A27EE40688CBB53A12C25583B&amp;_z=z">Guillain-Barr&eacute;s syndrom</a> </li>
            <li><a href="~/link.aspx?_id=BC5DE46115F34734BB2F9F4265669616&amp;_z=z">Myastenia gravis</a> </li>
            <li><a href="~/link.aspx?_id=728DA650142144B9BD0A09E4ED8D3E3D&amp;_z=z">Trombotisk trombocytopenisk purpura</a> (TTP)/<a href="~/link.aspx?_id=D3C1542A33FC427A8B7A910831EE8D60&amp;_z=z">h&aelig;molytisk ur&aelig;misk syndrom</a>&nbsp;(HUS) </li>
            <li>Hyperkolesterol&aelig;mi </li>
            <li>Fjernelse af anti-A og/eller anti-B forud for transplantation med major AB0 uforligelig nyre - anvendes efterh&aring;nden hyppigt i Danmark </li>
        </ul>
        </li>
    </ul>
    </li>
    <li>Plasmamodulation
    <ul>
        <li>Hyperkolesterol&aelig;mi </li>
    </ul>
    </li>
    <li>Autolog stamcelleh&oslash;stning
    <ul>
        <li>De to hyppigste indikationer:
        <ul>
            <li><a href="~/link.aspx?_id=FEA337568D6743A3B6DAE50693FED1CA&amp;_z=z">Myelomatose</a> </li>
            <li><a href="~/link.aspx?_id=25FC45605F1346C39C26A9873007A244&amp;_z=z">Non-Hodgkins lymfom</a></li>
        </ul>
        </li>
    </ul>
    </li>
    <li>Fotoferese
    <ul>
        <li>Forskellige former for kutant T-cellelymfom </li>
        <li>Progredierende sklerodermi</li>
    </ul>
    </li>
    <li>Erytrocytaferese
    <ul>
        <li>Arvelig h&aelig;mokromatose</li>
        <li>Forskellige h&aelig;maglobinopatier som led i erytrocytudskiftning</li>
        <li><a href="~/link.aspx?_id=2E232CB2AFD34E3B9A8A852F26E4B42B&amp;_z=z">Polycyth&aelig;mia vera</a></li>
    </ul>
    </li>
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