{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T16:55:05Z","timestamp":1789664105005,"version":"4.0.1"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T00:00:00Z","timestamp":1692576000000},"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":["Ther Apher Dial"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>With population aging and lifestyle changes, the number of patients with chronic limb\u2010threatening ischemia (CLTI) is increasing, and refractory or recurrent lesions are more common, especially in chronic dialysis patients. In March 2021, a new type of adsorptive cellulose bead column immobilized with dextran sulfate and L\u2010tryptophan for direct hemoperfusion (DHP) was approved by Japan's medical insurance system as a treatment for CLTI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed 17 cases of CLTI in dialysis patients treated with DHP using the novel column (Rheocarna) (DHP\u2010R) at our hospital from May 2021 to October 2022. The short\u2010term of efficacy of DHP\u2010R was judged qualitatively by the foot care team every 2\u2009weeks based on the assessment of skin color, warmth, ulcer epithelialization or shrinkage of the ulcer area, and foot pain. The final judgment of efficacy was made after the final DHP\u2010R session.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median age of patients was 66\u2009years, the median dialysis duration was 10\u2009years, 15 cases (88%) were male, and 15 cases (88%) had diabetes. The median total number of sessions was eight. In comparing the groups in which DHP\u2010R was effective and ineffective, there was no significant difference in any factors including patient background data (i.e., age, diabetes, low\u2010density lipoprotein cholesterol, hemoglobin, dialysis duration, etc.), type of anticoagulants, and presence of episodes of blood pressure drop or circuit clotting during session. Three cases with symptomatic hypotension during the session and two cases with circuit clotting that did not improve with increased heparin dose all resolved immediately after changing the anticoagulant from heparin to nafamostat mesylate (NM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Identification of patients' characteristics in which DHP\u2010R is favorable and some reliable index that allow a rapid decision to continue DHP\u2010R are needed. In addition, validating whether the use of NM as anticoagulant affects the efficacy of DHP\u2010R for CTLI treatment remains a challenge to resolve.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1744-9987.14049","type":"journal-article","created":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T06:53:30Z","timestamp":1692687210000},"page":"1010-1016","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Short term\u2010efficacy and tolerability of Rheocarna, a novel direct hemoperfusion adsorptive column, for chronic limb\u2010threatening ischemia in dialysis patients: A single\u2010center case series"],"prefix":"10.1111","volume":"27","author":[{"given":"Eri","family":"Imai","sequence":"first","affiliation":[{"name":"Department of Nephrology Itabashi\u2010Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuzo","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Department of Nephrology Itabashi\u2010Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ainori","family":"Hoshimoto","sequence":"additional","affiliation":[{"name":"Department of Nephrology Itabashi\u2010Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rina","family":"Hisada","sequence":"additional","affiliation":[{"name":"Department of Nephrology Itabashi\u2010Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makiko","family":"Harano","sequence":"additional","affiliation":[{"name":"Department of Nephrology Itabashi\u2010Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emi","family":"Anno","sequence":"additional","affiliation":[{"name":"Department of Nephrology Itabashi\u2010Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So","family":"Hagiwara","sequence":"additional","affiliation":[{"name":"Department of Nephrology Itabashi\u2010Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Ozaki","sequence":"additional","affiliation":[{"name":"Department of Cardiology Itabashi\u2010Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroko","family":"Torii","sequence":"additional","affiliation":[{"name":"Department of Plastic surgery Itabashi\u2010Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Tsukamoto","sequence":"additional","affiliation":[{"name":"Department of Nephrology Itabashi\u2010Chuo Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,21]]},"reference":[{"issue":"1","key":"e_1_2_8_2_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ejvs.2019.05.006","article-title":"Global vascular guidelines on the management of chronic limb\u2010threatening ischemia","volume":"58","author":"Conte MS","year":"2019","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61249-0"},{"key":"e_1_2_8_4_1","unstructured":"JCS\/JSVS.Guideline on the management of peripheral arterial disease.2022. 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