REDUCTION OF PLASMA COLD AGGLUTININ TITERS BY MEANS OF PLASMAPHERESISTO PREPARE A PATIENT FOR CORONARY-BYPASS SURGERY

A 53-year-old man with abnormally elevated cold agglutinins was treate d successfully by plasma exchange so that he was able to sustain coron ary artery surgery and extracorporeal circulation. Two plasma exchange s, consisting in the exchange of one plasma volume with a 5% albumin s olution each, were performed in our intensive care unit with careful m onitoring of vital parameters. The plasma exchanges resulted in a redu ction of the titer of the cold agglutinins and of the thermal amplitud e as well. With the exception of postoperative bleeding requiring re-i ntervention, the patient was successfully operated and could be dismis sed on the 16th postoperative day in good condition.