EFFECTS OF EXTRACORPOREAL HEMAPHERESIS THERAPY ON BLOOD RHEOLOGY

The blood flow property is one of the factors determining blood perfus ion and oxygen supply. The viscosity of the blood is primarily related to the hematocrit, but also to the amount of fibrinogen and other mac romolecules present in the blood. Patients with ischemic heart disease have shown a rapid and safe improvement in their hemorheological stat e when treated with heparin-induced extracorporeal low-density lipopro tein (LDL) precipitation (HELP). In this study we used two extracorpor eal hemapheresis methods, plasmapheresis (PP) and immunoadsorption (IA ), in 15 patients (eight patients treated with PP and seven patients w ith LA) with various diseases. Hemorheological variables and plasma fi brinogen were measured before and after the first and before the third treatment performed at 3 consecutive days. The aim of our study was t o investigate the immediate effects of these two treatment modalities on the flow properties of blood. Immediately after the first PP and IA session statistically significant declines in plasma fibrinogen conce ntration, plasma viscosity, whole blood viscosity, and erythrocyte agg regation tendency were found. These changes persisted before the third treatment session. The erythrocyte fluidity and hematocrit remained u nchanged. We conclude that extracorporeal hemapheresis therapy, with p lasmapheresis or immunoadsorption, affects the blood rheology by decre asing the plasma viscosity and erythrocyte aggregation tendency. The d ecrease in plasma fibrinogen is probably the main factor underlying th at, but other factors such as a decrease in immunoglobulins may also b e of importance. (C) 1997 Wiley-Liss, Inc.