Efficacy and Safety of Using Designed Auxiliary Lines in Standard <scp>CRRT</scp> Machines for <scp>DFPP</scp> Treatment

The demand for double-filtration plasmapheresis (DFPP) in clinical settings is growing steadily, yet the range and availability of specialized equipment designed to support DFPP are relatively limited. We aimed to assess the efficacy and safety of a designed auxiliary line for DFPP treatment using standard continuous renal replacement treatment (CRRT) machines. This prospective self-controlled study was conducted between May 2021 and April 2024. Patients who underwent DFPP treatment using both specialized DFPP machines and standard CRRT machines (using designed auxiliary line) were enrolled in the study. DFPP sessions were divided into the specialized DFPP machine group and the standard CRRT machine group. The rates of completed DFPP treatments, DFPP cost, circuit clotting, hypotension, anaphylaxis, hypocalcemia, and nurse operating time were compared. A total of 440 DFPP sessions were performed for 80 patients, with 330 (75.0%) sessions in the specialized DFPP machine group and 110 (25.0%) in the standard CRRT machine group. There were no statistically significant differences between the two groups in terms of the completed DFPP treatment rate (89.4% vs. 88.2%, p = 0.724), circuit clotting (8.2% vs. 7.3%, p = 0.760), anaphylaxis (12.7% vs. 11.8%, p = 0.803), hypotension (10.6% vs. 9.1%, p = 0.650), hypocalcemia (17.3% vs. 20.0%, p = 0.519), and nurse operation time (35.08 ± 2.27 min vs. 36.62 ± 1.94 min, p = 0.082). However, the cost per DFPP session in the standard CRRT machine group was lower than in the specialized DFPP machine (976.81 ± 14.38 $ vs. 1007.43 ± 35.30 $, p < 0.001). Standard CRRT machines can effectively and safely perform DFPP treatment using a specially designed auxiliary line, which is more cost-effective. Even in primary hospitals without specialized DFPP machines, CRRT machines can be used to perform DFPP treatment.