{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T07:10:42Z","timestamp":1774077042936,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T00:00:00Z","timestamp":1664928000000},"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":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Double\u2010filtration plasmapheresis (DFPP) has been utilized for immunomodulation in kidney transplantation. Anticoagulation is important to maintain circuit patency during DFPP. We aimed to compare the efficacy and safety of regional citrate anticoagulation (RCA) with systemic heparin anticoagulation during DFPP in kidney transplant recipients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study was conducted to compare the efficacy and safety of RCA (RCA\u2010DFPP) to systemic heparin anticoagulation (Hep\u2010DFPP) for DFPP among kidney transplant recipients in a single tertiary center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 112 sessions of DFPP were performed for 23 subjects, of which 62 sessions were RCA\u2010DFPP and 50 sessions were Hep\u2010DFPP. There were 13 sessions (11.6%) of premature circuit clotting, 10 sessions (16.1%) for RCA\u2010DFPP and 3 sessions (6.0%) for Hep\u2010DFPP (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.10). All premature circuit clotting episodes occurred in subjects who underwent DFPP through a vascular catheter. Premature circuit clotting was associated with the use of a vascular catheter (odds ratio [OR] 14.2, 95% confidence interval [CI] 2.7\u201073.7; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.01) and high postfilter ionized calcium (OR 12.7, 95% CI 1.4\u2010112.5; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.01). There was no major bleeding event. Hep\u2010DFPP was associated with higher occurrence of hypocalcemia (OR 1.1, 95% CI 1.0\u20101.2; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.01) and metabolic acidosis (OR 1.4, 95% CI 1.2\u20102.0; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.04), while hypomagnesemia was more common for RCA\u2010DFPP (OR 2.9, 95% CI 1.1\u20107.4; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Amongst kidney transplant patients who receive DFPP therapy, RCA\u2010DFPP may be comparable to Hep\u2010DFPP for the maintenance of circuit patency. Functioning vascular access is vital in avoiding premature clotting of the circuit. Close monitoring of electrolyte imbalances and coagulopathy related to DFPP is recommended.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jca.22019","type":"journal-article","created":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T12:53:26Z","timestamp":1664974406000},"page":"16-23","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Regional citrate anticoagulation vs systemic heparin anticoagulation for double\u2010filtration plasmapheresis"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2677-7996","authenticated-orcid":false,"given":"Swee Ping","family":"Teh","sequence":"first","affiliation":[{"name":"Department of Renal Medicine Singapore General Hospital  Singapore Republic of Singapore"},{"name":"Department of General Medicine\u2010Renal Medicine Sengkang General Hospital  Singapore Republic of 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