{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T05:01:53Z","timestamp":1773032513595,"version":"3.50.1"},"reference-count":11,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Pre\u2010set fixed\u2010dose albumin replacement fluid for double filtration plasmapheresis (DFPP) can result in progressive albumin deficit, along with other untargeted protein, leading to loss of osmotic pressure, and subsequently hypotension. This can occur in up to 6% of DFPP procedures. In this study, we aim to determine the serum albumin deficit with fixed\u2010dose replacement regime and estimate the required practical supplementary regime for the discrepancy. We compared the change in serum albumin level among patients treated with DFPP given fixed\u2010dose 10% plasma replacement volume with albumin 5% concentration versus patients given additional replacement with albumin 20% concentration. Seventy\u2010seven DPFF procedures were performed in 16 patients with various neurological disorders. In average, each patient received 4.8 DFPP procedures (Range 3\u20137) per treatment. Eight patients were given fixed\u2010dose albumin replacement and remaining 8 had additional albumin 20% replacement. Twenty\u2010one (27.3%) procedures had additional replacement. The average change in serum albumin post\u2010DFPP procedures was a reduction of 2.4\u2009g\/L (SD 3.0) with fixed\u2010dose replacement and an increment of 0.1\u2009g\/L (SD 2.8) for procedures with additional human albumin 20% replacement (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.003). In average, additional 78.6\u2009mL (50\u2013500\u2009mL in up to 5 divided replacements) of albumin 20% replacement given to patients with post\u2010DFPP serum albumin lower than 34\u2009g\/L, or in those with post\u2010DFPP negative serum albumin balance depending on severity effectively reduces post\u2010DFPP albumin deficit. In conclusion, fixed\u2010dose albumin replacement for DFPP results in progressive albumin deficits with successive procedures. Addition albumin supplementation may be required.\n                  <\/jats:p>","DOI":"10.1002\/jca.70101","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T09:50:06Z","timestamp":1772963406000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Determining the Optimal Albumin Concentration in the Replacement Fluid for Double Filtration Plasmapheresis in Autoimmune Neurological Disorders: A Preliminary Study"],"prefix":"10.1002","volume":"41","author":[{"given":"Kit Mun","family":"Loke","sequence":"first","affiliation":[{"name":"Neurology and Geriatric Outpatient Department Sunway Medical Centre  Subang Jaya Selangor Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4708-3734","authenticated-orcid":false,"given":"Fu Liong","family":"Hiew","sequence":"additional","affiliation":[{"name":"Neurology Unit, Division of Medicine Sunway Medical Centre  Subang Jaya, Selangor Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1744\u20109987.13548"},{"key":"e_1_2_13_3_1","first-page":"406","article-title":"Double Filtration Plasmapheresis","volume":"26","author":"Agishi T.","year":"1980","journal-title":"Transactions\u2014American Society for Artificial Internal Organs"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.tp.0000296103.34735.b8"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21705"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-9987.2012.01105.x"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2018.05.023"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1594.1992.tb00333.x"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.13749"},{"key":"e_1_2_13_10_1","unstructured":"https:\/\/www.asahi\u2010kasei.co.jp\/medical\/en\/apheresis\/product\/equipment\/sigma\/."},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21950"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2017.08.009"}],"container-title":["Journal of Clinical Apheresis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.70101","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jca.70101","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.70101","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:10:37Z","timestamp":1773029437000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jca.70101"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1002\/jca.70101"],"URL":"https:\/\/doi.org\/10.1002\/jca.70101","archive":["Portico"],"relation":{},"ISSN":["0733-2459","1098-1101"],"issn-type":[{"value":"0733-2459","type":"print"},{"value":"1098-1101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"2025-12-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70101"}}