{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T14:10:16Z","timestamp":1768399816905,"version":"3.49.0"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,9,14]],"date-time":"2015-09-14T00:00:00Z","timestamp":1442188800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004329","name":"Slovenian Research Agency","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004329","id-type":"DOI","asserted-by":"crossref"}]},{"name":"University Medical Center Ljubljana","award":["20140232"],"award-info":[{"award-number":["20140232"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In plasma exchange (<jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>), contrary to dialysis, there is no ultrafiltration, and the volume of anticoagulant contributes to volume overload of the patient and might also reduce <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content> efficiency through dilution. To reduce the volume of citrate, we compared 4 and 15% citrate anticoagulation protocols in <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content> in a randomized study, aiming to evaluate <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content> efficacy, anticoagulation efficiency, and overall safety. In addition to standard biochemical analyses during <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content> treatments, the elimination rate (<jats:styled-content style=\"fixed-case\">ER<\/jats:styled-content>) of immunoglobulins was calculated to evaluate <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content> efficacy. Anticoagulation was evaluated by postfilter ionized calcium, visual evaluation of the extracorporeal system, and change in the sieving coefficient (<jats:styled-content style=\"fixed-case\">SC<\/jats:styled-content>) during <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>. Accumulation of citrate was determined by calculating the total\u2010to\u2010ionized calcium ratio and measuring the citrate concentration after <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>. One hundred forty procedures (70 in each group) were performed in 37 patients. The mean citrate infusion rate was 197\u2009\u00b1\u200910\u2009mL\/h in the 4% and 59\u2009\u00b1\u20095.5\u2009mL\/h in the 15% groups, respectively; the total volume of infused citrate was 502\u2009\u00b1\u200977\u2009mL versus 164\u2009\u00b1\u200952\u2009mL (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). <jats:styled-content style=\"fixed-case\">ER<\/jats:styled-content> for immunoglobulin G (0.57\u2009\u00b1\u20090.06 vs. 0.55\u2009\u00b1\u20090.1, <jats:italic>P<\/jats:italic>\u2009=\u20090.18), <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>, and <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content> were comparable. Ionized calcium was stable during the procedures, and there were no significant side effects. Although postfilter ionized calcium was on the upper limit of the target range (0.41\u2009\u00b1\u20090.16 vs. 0.37\u2009\u00b1\u20090.14\u2009mmol\/L, <jats:italic>P<\/jats:italic>\u2009=\u20090.38), the visual assessment score was excellent, and even a rise in <jats:styled-content style=\"fixed-case\">SC<\/jats:styled-content> was observed during the procedures in both groups. The total\u2010to\u2010ionized calcium ratio was increased in 20 versus 22% of procedures, and citrate concentrations after <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content> were also similar (1306\u2009\u00b1\u2009441 vs. 1263\u2009\u00b1\u2009405\u2009\u03bcmol\/L). To conclude, we were unable to show superior <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content> efficacy in the 15% citrate group, but we significantly reduced the infused volume, which is important in patients with fluid overload. Both citrate protocols were found to provide excellent anticoagulation without significant metabolic disturbances or other side effects, confirming the safety of 15% citrate as anticoagulant during <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>.\u2003<\/jats:p>","DOI":"10.1111\/aor.12559","type":"journal-article","created":{"date-parts":[[2015,9,14]],"date-time":"2015-09-14T05:51:05Z","timestamp":1442209865000},"page":"368-375","source":"Crossref","is-referenced-by-count":12,"title":["Treatment Efficacy and Safety During Plasma Exchange With Citrate Anticoagulation: A Randomized Study of 4 Versus 15% Citrate"],"prefix":"10.1111","volume":"40","author":[{"given":"Manja","family":"Antonic","sequence":"first","affiliation":[{"name":"General Hospital Celje  Celje Slovenia"},{"name":"University Medical Center Ljubljana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5394-3729","authenticated-orcid":false,"given":"Jakob","family":"Gubensek","sequence":"additional","affiliation":[{"name":"University Medical Center Ljubljana"},{"name":"Faculty of Medicine University of Ljubljana  Ljubljana Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7473-3731","authenticated-orcid":false,"given":"Jadranka","family":"Buturovic\u2010Ponikvar","sequence":"additional","affiliation":[{"name":"University Medical Center Ljubljana"},{"name":"Faculty of Medicine University of Ljubljana  Ljubljana Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"Ponikvar","sequence":"additional","affiliation":[{"name":"University Medical Center Ljubljana"},{"name":"Faculty of Medicine University of Ljubljana  Ljubljana Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,9,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2008.02.360"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21276"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfq575"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2011.11.030"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.5414\/CNP68302"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2004.12.002"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.1999.00671.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1594.2010.01038.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000245646"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0102748"},{"key":"e_1_2_8_12_1","unstructured":"U.S. Food and Drug Administration.Safety: triCitrasol 2000 Apr 04. 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