{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:38:36Z","timestamp":1789609116080,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T00:00:00Z","timestamp":1618272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate effectiveness and safety of therapeutic plasma exchange (TPE) and dextran\u2010sulfate plasma adsorption (DSA) for extracorporeal removal of soluble Fms\u2010like tyrosine kinase\u20101 (sFlt\u20101) as part of expectant management of preeclampsia at extremely preterm gestational age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective case series of six patients with preeclampsia at &lt;28\u2009weeks of gestation, treated with DSA or TPE. Laboratory results, clinical characteristics and neonatal outcomes were collected from charts and National Perinatal Information System.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fetal growth restriction (FGR) was diagnosed in all cases. Pregnancy was prolonged for a median of 14 (range 5\u201074) days from admission and 10 (3\u201073) days from first apheresis. A mixed effects model showed a decrease in sFlt\u20101 and sFlt\u20101\/PlGF ratio during DSA\/TPE (significant effect of time [before\/after]), which was comparable between DSA and TPE (no effect of procedure type). Median absolute reduction in sFlt\u20101 was 42% (inter\u2010quartile range [IQR] 13%\u201057%) during DSA and 34% (16%\u201040%) during TPE; for sFlt\u20101\/PlGF ratio it was 29% (22%\u201036%) and 38% (29%\u201042%), respectively. All procedures were well tolerated by fetuses. Anaphylactoid reaction, often with angioedema, occurred in 4\/6 patients undergoing DSA and was attributed to bradykinin activation. One patient developed wound hematoma after cesarean section, possibly attributed to depletion coagulopathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>As potential novel treatment of early preeclampsia, a non\u2010selective and widely available TPE was comparable to DSA regarding sFlt\u20101 reduction but was associated with fewer side\u2010effects. Both seem to allow maternal stabilization and pregnancy prolongation even when early preeclampsia is complicated by FGR.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jca.21899","type":"journal-article","created":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T18:48:45Z","timestamp":1618339725000},"page":"595-605","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Therapeutic plasma exchange and dextran\u2010sulfate plasma adsorption as extracorporeal treatments of extremely preterm preeclampsia with fetal growth restriction"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5394-3729","authenticated-orcid":false,"given":"Jakob","family":"Gubensek","sequence":"first","affiliation":[{"name":"Department of Nephrology University Medical Centre Ljubljana  Ljubljana Slovenia"},{"name":"Faculty of Medicine University of Ljubljana  Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Ponikvar","sequence":"additional","affiliation":[{"name":"Department of Nephrology University Medical Centre Ljubljana  Ljubljana Slovenia"},{"name":"Faculty of Medicine University of Ljubljana  Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2597-0188","authenticated-orcid":false,"given":"Tanja","family":"Premru Srsen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Ljubljana  Ljubljana Slovenia"},{"name":"Department of Perinatology, Division of Obstetrics and Gynecology University Medical Centre Ljubljana  Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vesna","family":"Fabjan Vodusek","sequence":"additional","affiliation":[{"name":"Department of Perinatology, Division of Obstetrics and Gynecology University Medical Centre Ljubljana  Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manfred Georg","family":"Moertl","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Clinical Center  Klagenfurt Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miha","family":"Lucovnik","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Ljubljana  Ljubljana Slovenia"},{"name":"Department of Perinatology, Division of Obstetrics and Gynecology University Medical Centre Ljubljana  Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,13]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"American College of Obstetricians and Gynecologists.Task Force on Hypertension in Pregnancy. 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