{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T08:24:06Z","timestamp":1759479846554,"version":"3.37.3"},"reference-count":42,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,9,7]],"date-time":"2016-09-07T00:00:00Z","timestamp":1473206400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1TR000075"],"award-info":[{"award-number":["UL1TR000075"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Hydroxyethyl starch (HES) is reportedly associated with an increased risk of renal failure and death when used for fluid resuscitation in critically ill patients. HES can be used during therapeutic leukocytapheresis (TL) procedures to enhance cell separation. The purpose of this study was to evaluate the occurrence of adverse events associated with HES during TL procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN AND METHODS<\/jats:title><jats:p>We performed a retrospective review of patients who underwent TL with and without HES in the period 2009 to 2013 at six academic medical institutions.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A difference\u2010in\u2010difference regression analysis was used to estimate the mean change before and after TL in selected outcomes in the HES group relative to the average change in the non\u2010HES group. Selected outcomes included serum creatinine, estimated glomerular filtration rate (eGFR), and white blood cell (WBC) count. A total of 195 patients who underwent 278 TL procedures were studied. We found no significant differences in serum creatinine levels and eGFR on Days 1 and 7 after TL procedure between patients who received and those who did not receive HES. The rate of adverse events and overall and early mortality were similar in both groups. Patients with acute myeloid leukemia who received HES had greater WBC reduction when HES was used. Additionally, patients who received HES had improvement in pulmonary leukostasis symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>HES, used at low doses during TL procedures, was not associated with adverse events previously ascribed to its use as a volume expander.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.13795","type":"journal-article","created":{"date-parts":[[2016,9,7]],"date-time":"2016-09-07T15:19:00Z","timestamp":1473261540000},"page":"2848-2856","source":"Crossref","is-referenced-by-count":8,"title":["Use of hydroxyethyl starch in leukocytapheresis procedures does not increase renal toxicity"],"prefix":"10.1111","volume":"56","author":[{"given":"Monica B.","family":"Pagano","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine University of Washington Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Harmon","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Michigan Ann Arbor Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Cooling","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Michigan Ann Arbor Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Connelly\u2010Smith","sequence":"additional","affiliation":[{"name":"Division of Hematology University of Washington Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven A.","family":"Mann","sequence":"additional","affiliation":[{"name":"University of Alabama School of Medicine Birmingham Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huy P.","family":"Pham","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Alabama at Birmingham Birmingham Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marisa B.","family":"Marques","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Alabama at Birmingham Birmingham Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annette J.","family":"Schlueter","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Iowa Iowa City Iowa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosemary","family":"Case","sequence":"additional","affiliation":[{"name":"Division of Transfusion Medicine Johns Hopkins Medical Institutions Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen E.","family":"King","sequence":"additional","affiliation":[{"name":"Division of Transfusion Medicine Johns Hopkins Medical Institutions Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guido","family":"Cataife","sequence":"additional","affiliation":[{"name":"Health Division IMPAQ International Columbia Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanyun","family":"Wu","sequence":"additional","affiliation":[{"name":"Bloodworks Northwest Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward C. C.","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Laboratory Medicine, Departments of Pediatrics and Pathology, Children's National Medical Center George Washington School of Medicine and Health Sciences Washington DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8654-3732","authenticated-orcid":false,"given":"Jeffrey L.","family":"Winters","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Division of Transfusion Medicine Mayo Clinic Rochester Minnesota."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,9,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3109\/10428190009053534"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2014.01.004"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21276"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/ael333"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31819cc1a0"},{"issue":"1","key":"e_1_2_8_7_1","first-page":"CD007594","article-title":"Hydroxyethyl starch (HES) versus other fluid therapies: effects on kidney function","author":"Dart AB","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa070716"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2010.05.002"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1209759"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc11358"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1204242"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e318258fee7"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.04.009"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f839"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.430"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-013-2840-0"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-013-2863-6"},{"key":"e_1_2_8_19_1","unstructured":"FDA Safety Communication: Boxed warning on increased mortality and severe renal injury and additional warning on risk of bleeding for use of hydroxyethyl starch solutions in some settings [Internet]. Silver Spring (MD): U.S. Food and Drug Administration; 2013 [cited 2016 Jan]. Available from:http:\/\/www.fda.gov\/BiologicsBloodVaccines\/SafetyAvailability\/ucm358271.htm."},{"key":"e_1_2_8_20_1","unstructured":"Hydroxyethyl\u2010starch solutions (HES) no longer to be used in patients with sepsis or burn injuries or in critically ill patients: HES will be available in restricted patient populations [Internet]. London:Pharmacovigilance Risk Assessment Committee of the European Medicines Agency; 2013 Dec 19 [cited 2016 Jan]. Available from:http:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/Referrals_document\/Solutions_for_infusion_containing_hydroxyethyl_starch\/European_Commission_final_decision\/WC500162361.pdf."},{"key":"e_1_2_8_21_1","unstructured":"US Food and Drug Administration adds black boxed warning to hydroxyethyl starch (HES) [Internet]. Vancouver (BC):American Society for Apheresis; 2013 Sep 12 [cited 2016 Jan]. 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