Blood purification · 2026
Nursing Protocols and Observed Outcomes of TR-350 Immunoadsorption in Neuromyelitis Optica Spectrum Disorder: A Single-Center Experience of 334 Procedures.
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Wang Limin, Alemasi Akehu, Liu Jing, Gong Yong, Zhang Yin, Xiong Yunjin
Аннотация
INTRODUCTION: We describe an institutional nursing protocol used for patients with neuromyelitis optica spectrum disorder (NMOSD) undergoing TR-350 tryptophan immunoadsorption (IA) therapy. We retrospectively analyzed the clinical and nursing records of 67 patients with NMOSD who underwent TR-350 IA between January 2019 and August 2025.
METHODS: We evaluated 334 treatment sessions and recorded demographic characteristics, observed clinical and serological changes, adverse events, and device alarms. Nursing management before, during, and after the procedure was reviewed.
RESULTS: After the IA treatment course, reductions in the median Expanded Disability Status Scale score and the geometric mean anti-aquaporin-4 immunoglobulin G (AQP4-IgG) titer, together with improvement in visual acuity, were observed. Laboratory testing revealed hypofibrinogenemia (<1.0 g/L) in 13 of 67 patients (19.4%). Nurses identified hypotension in two sessions (2/334, 0.6%) and catheter-site bleeding in one session (1/334, 0.3%); in all, 29 device-alarm events were recorded. With nursing intervention and timely troubleshooting, 333 of 334 sessions were completed; one session (0.3%) was terminated prematurely because of extracorporeal circuit clotting.
CONCLUSION: TR-350 IA demonstrated feasibility and safety in this cohort of patients with steroid-refractory NMOSD. Adherence to nursing protocols refined locally from institutional standard operating procedures and clinical experience, together with proactive management of complications, supported a high treatment completion rate and patient safety.
METHODS: We evaluated 334 treatment sessions and recorded demographic characteristics, observed clinical and serological changes, adverse events, and device alarms. Nursing management before, during, and after the procedure was reviewed.
RESULTS: After the IA treatment course, reductions in the median Expanded Disability Status Scale score and the geometric mean anti-aquaporin-4 immunoglobulin G (AQP4-IgG) titer, together with improvement in visual acuity, were observed. Laboratory testing revealed hypofibrinogenemia (<1.0 g/L) in 13 of 67 patients (19.4%). Nurses identified hypotension in two sessions (2/334, 0.6%) and catheter-site bleeding in one session (1/334, 0.3%); in all, 29 device-alarm events were recorded. With nursing intervention and timely troubleshooting, 333 of 334 sessions were completed; one session (0.3%) was terminated prematurely because of extracorporeal circuit clotting.
CONCLUSION: TR-350 IA demonstrated feasibility and safety in this cohort of patients with steroid-refractory NMOSD. Adherence to nursing protocols refined locally from institutional standard operating procedures and clinical experience, together with proactive management of complications, supported a high treatment completion rate and patient safety.