This study has shown that cryofilter plugging correlates with pretreatment pathologic macromolecule concentrations (e.g.
rheumatoid factor and
immune complexes) in the treatment of patients with
rheumatoid arthritis. Pathologic macromolecules are concentrated relative to
albumin in the
cryogel. Molecular aggregation in the
cryogel depends upon
heparin concentration, exhibiting maximum aggregation in a specific range of
heparin concentrations. Molecular aggregation in
cryogel increases with decreasing temperature. In the use of cryofiltration in over 50
rheumatoid arthritis patients, clinical improvement has accompanied the removal of
cryogel and the pathologic macromolecules it contains. Filter plugging or
cryogel formation may be indicators of disease activity. Formation of
cryogel is variable depending upon type of disease, severity of disease, temperature,
heparin concentration, and membrane structure. These factors are important parameters to consider to optimize conditions for removal of
cryogel and for continuing improvement of plasma therapeutic techniques for the treatment of
rheumatoid arthritis.