The present application relates to systems and method for performing plasmapheresis and, more particularly, to plasmapheresis systems and methods in which the volume of source or raw plasma product that may be collected from a particular donor is optimized.
Plasmapheresis is an apheresis procedure in which whole blood is withdrawn from a donor, the plasma separated from the cellular blood components (red blood cells, platelets and leukocytes) and retained, and the cellular blood components returned to the donor. The separation of the plasma from the cellular components is typically accomplished in an automated procedure by centrifugation or membrane filtration.
In automated plasmapheresis, whole blood is drawn from the donor, mixed at a specified ratio with anticoagulant (“AC”), and then separated into anticoagulated plasma and red blood cells and other cellular components. Once a target volume of anticoagulated plasma (or “plasma product”) has been collected, as determined by a weigh scale associated with a plasma collection container, the withdrawal of whole blood from the donor ceases, and the red blood cells and other cellular components are returned to the donor. Often, the plasma product is collected in multiple collection and reinfusion cycles, until the total target volume of anticoagulated plasma has been collected. The anticoagulated plasma is used for later transfusion or further manufacturing.
Plasma that is collected to serve as a source material (“source plasma”) for further manufacturing is collected from multiple donors and combined or pooled together for this purpose. The FDA issued guidelines for registered blood collection centers as to the volume of plasma that may be collected as source plasma during plasmapheresis in order to improve the consistency of procedures for manufacturing source plasma, and to minimize the opportunity for staff error. (FDA Memo: “Volume Limits-Automated Collection of Source Plasma (Nov. 4, 1992)”). The FDA Memo noted inconsistencies due to the various types of anticoagulant solutions used, differing concentrations of the anticoagulant, and the range of anticoagulant to plasma ratios.
The FDA Memo set forth a simplified plasma volume nomogram, reproduced in the table shown in
The simplified nomogram set forth in the FDA Memo has been the predominant method for determining plasma product collection volumes used by blood collection centers. Therefore, the plasmapheresis devices used at such centers are commonly programmed to collect a specified volume/weight of anticoagulated plasma (assuming a known density) in accordance with the maximum collection volume permitted by the FDA nomogram, with the anticoagulant being added to the whole blood at a 1:16 or 0.06 ratio.
One simplification made in the FDA nomogram is to exclude the consideration of donor hematocrit in determining the collection volume the plasma product. However, the relative proportions of raw plasma and anticoagulant in the plasma product depends on the donor blood hematocrit and the ratio at which the AC is combined with the donor's whole blood. As a consequence, higher hematocrit donors reach the maximum collection volume set forth in the FDA nomogram before reaching the maximum (raw) plasma volume that may be safely collected from the donor. This represents an inefficiency for the plasma collection center, in that volume of raw plasma that is collected is less than the maximum amount possible.
Further, the amount of plasma that may be safely collected from a donor can depend on factors in addition to the donor's weight and hematocrit, such as the donor's height, sex and age, as these factors affect the donor's total blood volume (and volume of plasma).
Because the source plasma from multiple donors is combined, it is important to maximize the plasma volume that may be collected from each individual donor, as even small gains in volume collected from each individual donor, when added together, result in a meaningful increase in the total volume of the pooled plasma. If a plasmapheresis device were to be able to better target the raw plasma volume, more plasma proteins could be collected from each donor, improving the overall efficiency of the plasma collection center. Accordingly, by way of the present disclosure, systems and methods for optimizing the volume of plasma collected are provided which are consistent with donor safety and comfort.
By way of the present disclosure, methods are provided for operating a plasmapheresis system to collect a volume of anticoagulated plasma volume (i.e., the plasma product) that insures that the total volume of raw plasma in the plasma product is the maximum that may be collected from a particular donor consistent with donor safety and comfort, whether as dictated the donor's unique physical characteristics, as indicated by the FDA nomogram or by some other methodology.
In keeping with a first aspect of the disclosure, a method is provided for operating a plasmapheresis system to collect a plasma product volume that comprises the maximum allowable volume/weight of raw plasma in accordance with the limits set forth in the FDA nomogram based on the weight of the donor.
In order to collect the maximum volume/weight of raw plasma permitted by the FDA nomogram, a modified nomogram is provided that utilizes the donor's hematocrit to calculate a target volume/weight for a plasma product having the maximum volume of raw plasma permitted by the FDA nomogram. A calculated volume/weight of raw plasma is compared to the maximum volume/weight for the raw plasma permitted by the FDA nomogram. If the calculated volume/weight of raw plasma is less than the maximum permitted volume/weight, the volume/weight of the plasma product to be collected is adjusted upward from the maximum volume/weight permitted by the FDA nomogram for the plasma product by an amount equal to the difference plus the additional amount of anticoagulant that is added to process the additional volume/weight of plasma.
Thus, with the knowledge of the donor's hematocrit and the instrument's AC ratio, the volume of additional raw plasma that may be safely collected from the donor consistent with the limits set forth in the FDA nomogram is determined, and then the total volume/weight of plasma product to be collected based on the weight of the donor set forth in the FDA nomogram is adjusted accordingly.
Typically, plasmapheresis procedures involve sequential cycles of alternating phases, one in which whole blood is withdrawn from the donor and the plasma separated and collected, and the other in which the separated red blood cells and any other non-RBC cellular components are returned to the donor. The donor's hematocrit will change during the course of the plasmapheresis procedure, thus affecting the amount of anticoagulant in the plasma product collected from one cycle to the next.
Consequently, in the first aspect of the disclosure, before the commencement of the subsequent extraction/separation phase, a new hematocrit value for the donor is determined, and the target volume/weight of plasma product for the procedure is recalculated before the commencement of each extraction/separation phase to ensure that the maximum amount of raw plasma permitted by the FDA nomogram is collected.
In keeping with a second aspect, a further method for collecting a volume of plasma during an apheresis procedure is provided. The steps of the method comprise: determining a total whole blood volume Vb for the donor; determining a volume of raw plasma (VRP) that may be collected from the donor based on Vb; determining a target volume of plasma product (VPP) to be collected, wherein VPP is equal to the volume of raw plasma (VRP) to be collected plus a volume of anticoagulant (VAc) that is added to the VRP during the apheresis procedure, such that VPP=VRP*K, where K=(ACR*(1−Hct/100)+1)/(ACR*(1−Hct/100)), based on an anticoagulant ratio (ACR, defined as the ratio of donor blood volume to anticoagulant volume for donor blood having no anticoagulant) established for the procedure and a Hct of the donor; withdrawing whole blood from the donor; adding anticoagulant to the whole blood in an amount consistent with the ACR; separating plasma product from the whole blood; and transferring the plasma product to a collection container until the volume of plasma product in the collection container reaches VPP. Because the plasmapheresis procedure comprises multiple extraction/separation and return phases, the VPP for the procedure is recalculated before each extraction/separation phase is commenced, based on a value for the hematocrit of the donor determined prior to the start of each draw phase, and the target volume for the plasma product adjusted accordingly. Alternatively, VRP may be determined based on a calculated value for the donor's total plasma volume, based on Vb and the donor's hematocrit.
In a third aspect, a method for determining a volume of plasma product (VPP) that may be collected during an apheresis procedure is provided, wherein VPP is equal to a volume of raw plasma (VRP) that may be collected plus a volume of anticoagulant (VAc) that is added to the VRP during the apheresis procedure. The steps of the method comprise: determining a weight (Wkg) and sex (M or F) of the donor, determining a hematocrit (Hct) for the donor; determining the volume of raw plasma (VRP) that may be collected based on the weight (Wkg) and sex (M or F) of the donor; determining a ratio K between the VPP and the VRP, such that K=VPPNRP, based on an anticoagulant ratio (ACR) and the Hct of the donor; determining VPP, such that VPP=VRP*K. Further, K=(ACR*(1−Hct/100)+1)/(ACR*(1−Hct/100)). After VPP is determined, whole blood is withdrawn from the donor; anticoagulant is added to the whole blood in an amount consistent with the ACR; plasma product is separated from the whole blood; and plasma product is transferred to a collection container. After a desired amount of whole blood has been withdrawn from the donor, the red blood cells are returned to the donor. Then, the Hct of the donor and VPP are determined prior to each draw phase.
In a related aspect, the draw and separation steps are repeated until the volume of plasma product in the collection container reaches VPP.
In a related aspect, the donor's hematocrit subsequent to the first collection phase may be calculated by a volume balance, assuming that the donor's quantity of red blood cells is the same at the start of each draw cycle, while the total volume of blood decreases from one cycle to the next in an amount equal to the amount of raw plasma collected. Alternatively, the donor's hematocrit at the start of each draw cycle can be measured by an optical or other sensor.
In a further aspect, the volume of raw plasma that may be collected from a particular donor may be determined by any one of several different means. Such means include, e.g., the FDA nomogram, taking into account only the donor's weight; a modified FDA nomogram, further taking into account the donor's hematocrit, and taking a fraction of a total blood volume or total plasma volume calculated for a particular donor. The total blood volume or total plasma volume may be determined using, for example, Nadler's equations, Gilcher's Rule of Five, tables provided by the International Council for Standardization in Haematology (ICSH), or any other generally accepted method using the donor's height, weight, sex and age, consistent with the safety and comfort of the donor.
In a fourth aspect, an automated system for separating plasma from whole blood is provided that comprises a reusable hardware component and a disposable kit. The disposable kit further comprises i) a separator for separating whole blood into a plasma fraction and a concentrated cell fraction, the separator having an input having a blood line integrally connected thereto for transporting whole blood from a donor to the separator, a plasma output port integrally connected to a plasma collection container by a plasma line, and a concentrated cell outlet port integrally connected to a reservoir for receipt of concentrated cells prior to reinfusion to the donor; ii) a donor line terminating in a venipuncture needle for transporting whole blood from a donor to the blood line, iii) an anticoagulant line integrally connected to the blood line and configured to be connected to a source of anticoagulant for transporting anticoagulant to the donor line, and iv) a reinfusion line for transporting concentrated cells from the reservoir to the donor line.
The reusable hardware component further comprises i) a first peristaltic pump for delivering anticoagulant at a controlled rate into the blood line during a collection phase, ii) a second pump for delivering anticoagulated whole blood to the separator during the collection phase and for returning concentrated cellular components during a reinfusion phase, iii) a third pump for delivering concentrated cellular components from the separator to the reservoir during the collection phase, iv) a clamp associated with each of the blood line, plasma line, and reinfusion line, v) a weigh scale for weighing each of the plasma collection container, the reservoir and the source of anticoagulant, and vi) a programmable controller comprising a touch screen for receiving input from an operator, the programmable controller configured to receive a signal from each of the weigh scales and to automatically operate the first, second and third pumps and the clamps to separate whole blood into a plasma fraction and a concentrated cell fraction during the collection phase and to return concentrated cells to the donor during the reinfusion stage. The programmable controller is further configured to determine a target amount for the plasma product to be collected in the plasma collection container in accordance with any of the methods described herein, and to terminate the collection phase upon receiving a signal that the amount of plasma product in the plasma collection container equal to the target amount of the plasma product determined by the controller. In determining the target amount for the plasma product to be collected, the controller may be configured to calculate the hematocrit of the donor prior to the collection phase of each cycle. Alternatively, or additionally, the controller may receive a signal from a sensor or the like that is indicative of the donor's hematocrit. Further, the amount of plasma product in the plasma collection container may be determined by, e.g., the weigh scale associated with the plasma collection container or an optical sensor that directly measures the volume.
A more detailed description of the systems and methods in accordance with the present disclosure is set forth below. It should be understood that the description below of specific devices and methods is intended to be exemplary, and not exhaustive of all possible variations or applications. Thus, the scope of the disclosure is not intended to be limiting, and should be understood to encompass variations or embodiments that would occur to persons of ordinary skill.
In the context of the present application, plasmapheresis is performed on an automated system comprising a hardware component, generally designated 10, and a disposable set, generally designated 12, to collect plasma to be processed as source plasma. With reference to
The separator 14, best seen in
During plasmapheresis, anticoagulated whole blood enters the separator 14 through a whole blood input port 22. The plasma is separated by the spinning membrane filter and then passes out of a plasma output port 24, through a plasma line 26, and into a plasma collection container 28. Concentrated cells are pumped out of a concentrated cell output port 30 into a reservoir 32, where the cells remain until reinfusion to the donor.
The disposable set 12 also includes tubing lines for introducing whole blood from the donor into the system during collection and returning concentrated cells to the donor during reinfusion (donor line 34, which terminates in the venipuncture needle 36), and for transporting anticoagulated whole blood to the separator (blood line 38), concentrated cells into the reservoir (cell line 40), concentrated cells from the reservoir to the donor line (reinfusion line 42), plasma into the plasma collection container (plasma line 44), saline (saline line 46), and anticoagulant (AC line 48).
The hardware component 10 includes a programmable controller 50 and touch screen 52 with a graphical user interface (“GUI”) through which the operator controls the procedure. For example, the GUI permits entry of any of a donor ID, donor sex, donor height, donor weight, donor age, donor hematocrit/hemoglobin; a target saline infusion volume (if a saline protocol is selected), and a target plasma volume. The touch screen 52 also enables the operator to gather status information and handle error conditions.
Three peristaltic pumps are located on the front panel of the hardware component 10, including an AC pump 54, a blood pump 56, and a cell pump 58. The AC pump 54 delivers anticoagulant solution (AC) at a controlled rate into the blood line 38 as whole blood enters the set from the donor. The blood pump 56 delivers anticoagulated whole blood to the separator during the collection phase of the procedure and returns concentrated cellular components and, if desired, replacement fluid to the donor during the reinfusion phase of the procedure. The cell pump 58 delivers concentrated cellular components from the separator 14 to a reservoir during the collection phase.
The front panel also includes four clamps into which the disposable set 12 is installed, including a reinfusion clamp 60, a blood clamp 62, a saline clamp 64, and a plasma clamp 66. The reinfusion clamp 60 closes to block the reinfusion line (42) during the collection phase (
The hardware component 10 includes three weigh scales to monitor the current plasma collection volume (scale 68), the AC solution volume (scale 70), and the concentrated cellular content volume (scale 72). The system also includes various sensors and detectors, including a venous pressure sensor 74, a separator pressure sensor 76, optical blood detectors 78, and an air detector 80.
The donor is connected to the system throughout the procedure. As illustrated, the disposable set 12 includes a single venipuncture needle 36, through which whole blood is drawn from the donor in a collection phase (
Returning to
The cellular components are pumped from the separator 14 to the reservoir 32. The collection phase stops when the reservoir 32 reaches an expected volume of concentrated cells or if the target plasma collection volume has been achieved.
Then, the reinfusion phase begins. With reference to
In keeping with one aspect of the disclosure, the automated plasma collection device is configured to collect a volume/weight of anticoagulated plasma (i.e., the plasma product) having the maximum volume/weight of raw plasma permitted for the donor under the limits set forth in the FDA nomogram. In order to maximize the volume of raw plasma comprising the plasma product, the device is programmed with a nomogram that accounts for the donor's hematocrit. With the knowledge of the donor's hematocrit and the instrument's AC ratio, the total volume/weight of plasma product to be collected can be determined such that the plasma product includes the maximum volume/weight of raw plasma fraction that may be collected from a donor, consistent with the limits for total volume/weight of raw plasma set forth in the FDA nomogram. By having the computations programmed into the controller, the likelihood of operator error is diminished in comparison to the off-line calculation of the collection volume that is then entered into the instrument.
During plasmapheresis, when anticoagulant is mixed with whole blood as it is drawn from the donor, the anticoagulant is evenly distributed within the raw plasma in the blood. However, the amount of raw plasma in the whole blood is dependent on the hematocrit (Hct) of the whole blood. The following relationships are established:
Volume of RBC=Volume of Whole Blood*Hct/100. [1]
Volume of Raw Plasma=Volume of Whole Blood*(1−Hct/100). [2]
When anticoagulant is mixed with the whole blood, it is typically metered at an AC Ratio (ACR) of 16 parts of whole blood to 1 part of AC, or at 1 part of whole blood to 0.06 parts of AC.
ACR=Volume of Whole Blood/Volume of Anticoagulant (the donor blood having no anticoagulant). [3]
(This yields a slightly different result from the FDA nomogram, which, as noted above, standardizes the volume of anticoagulant that may be added to a 1:16 ratio of anticoagulant to anticoagulated blood, or 0.06 parts anticoagulant to 1 part anticoagulated blood.)
Volume of Anticoagulated Blood=Volume of Anticoagulant+Volume of Whole Blood. [4]
Combining equations gives:
Volume of Raw Plasma=ACR*Volume of Anticoagulant*(1−Hct/100). [5]
Since the red cells are given back to the donor:
Volume collected Plasma=Volume of Raw Plasma+Volume of Anticoagulant. [6]
Equations [5] and [6] can be combined to calculate the amount of anticoagulant in a given amount of collected plasma:
Volume of Anticoagulant=Volume of collected plasma/(1+ACR*(1−Hct/100)). [7]
Further:
Volume of collected Plasma=Volume of Raw Plasma*K, where K=(ACR*(1−Hct/100)+1)/(ACR*(1−Hct/100)). [8]
In view of the relationships expressed in the equations above, the volume of raw plasma contained within the volume of plasma product permitted under the FDA nomogram can be determined based upon the hematocrit of the donor. The results of such calculations are set forth in
As can be appreciated with reference to
The table set forth in
Alternatively, the volume of plasma product to be collected may be calculated by first determining a weight and hematocrit (Hct) for the donor; determining the volume of raw plasma (VRP) that may be collected based on the weight of the donor (Wkg); determining a ratio K between the VPP and the VRP, such that K=VPP/VRP, based on an anticoagulant ratio (ACR; 1:16 or 0.06:1, per the FDA nomogram) and the Hct of the donor; and determining VPP, such that VPP=VRP*K. Further, K=(ACR*(1−Hct/100)+1)/(ACR*(1−Hct/100)).
In a further alternative, the volume of plasma product that is to be collected (VPP) may be calculated by first determining the weight (Wkg) and hematocrit (Hct) of the donor; determining the volume of raw plasma (VRP) that may be collected based on the weight of the donor (Wkg); determining the volume of anticoagulant to be added (VAC) based on the anticoagulant ratio (ACR; 1:16 or 0.06:1, per the FDA nomogram) and the hematocrit of the donor such that VAc=VRP*(ACR*(1−Hct/100)); and determining the collection volume such that VPP=VRP+VAC.
Various methods may be used for determining the volume of raw plasma that may be collected based on the weight of the donor. For example, the weight of the donor may be multiplied by an established constant “K1” (such as 10 mL/kg). Alternatively, the weight of the donor may be segregated into weight categories, with a fixed volume established for each category (as in the FDA nomogram discussed above, in which the ranges of donor weight are divided into three categories).
Alternatively, a donor's plasma volume may be estimated based on the donor's total blood volume, and a volume of plasma that may be harvested consistent with donor safety and comfort may be based on this estimation. Methods utilizing donor parameters are commonly used estimate a donor's total blood volume. Examples of such methods include Nadler's equations (that take into account the height, sex and weight of the donor), Gilcher's Rule of Five (that takes into account sex, weight and morphology (obese, thin, normal or muscular), or the standards of the International Counsel for Standardization in Haematology (“ICSH) as set forth in Br. J. Haem. 1995, 89:748-56) (that take into account the height, weight, age and sex of the donor). Any other generally accepted methodology for determining donor's total blood volume may also be used. Once the donor's total blood volume is determined, the donor's plasma volume may be estimated by multiplying the total blood volume by a constant “K2”, where or K2 equals (1−Hct of the donor).
From an analysis of demographic, examination, and laboratory data from the 2015-2016 National Health and Nutrition Examination Survey, in which sex, age, height, weight, pregnancy data and hematocrit were extracted, presented in Pearson et al., Interpretation of measured red cell mass and plasma volume in adults: Expert Panel on Radionuclides of the International Council for Standardization in Haematology, British J. Haematology, 89: 748-756 (1995), (upon which the ICSH recommended formulae were derived), it has been determined that for donors having certain characteristics (namely low weight females with high hematocrits), up to 36% of the available plasma may be collected while staying within current regulations. Plasmapheresis procedures with such donors have been carried out routinely without adverse reactions, and thus are considered safe. This suggests that up to 36% of a donor's available plasma can be safely collected in a plasmapheresis procedure.
Given that only negative deviations of a donor's true blood volume from a predicted/calculated total blood volume present a potential risk, a further adjustment downward of the harvestable volume of plasma may be appropriate. Based on a consideration of the deviation between the calculated blood volume as determined in Pearson et al., cited above, and the experimental blood volume data presented in Retzlaff et al., Erythrocyte Volume, Plasma Volume, and Lean Body Mass in Adult Men and Women, J. Haematology, 33, 5:649-667 (1969), there is a 95% confidence that an individual's predicted blood volume will differ not more that 20.5%. Thus a scaling factor of 0.795 may be applied to determination of harvestable raw plasma being 36% of the donor's total plasma volume described above, so that 28.6% of a donor's calculated volume of raw plasma may be harvested, consistent with donor safety and comfort.
Alternatively, an adjustment VC may be made to the calculated volume of whole blood VWB before calculating the volume of harvestable plasma VRP, such the VRP=0.36(1−Hct)(VWB−VC). A regression analysis of the data presented by Retzlaff resulted in a determination of VC=523 mL.
Thus, the collection volume (the volume of plasma product) is determined based on the volume of raw plasma volume that may be collected from a particular donor, the donor's hematocrit, and the fixed anticoagulant ratio (ACR). Consequently, this methodology allows for more consistent control for the raw plasma volume of the donor, which is the variable most related to donor safety.
In practice, the operator enters into the system controller the collection volume for the plasma product for the particular donor, based on the target volume of raw plasma that may be harvested. The target plasma collection volume may be as set forth in
As noted above, plasmapheresis procedures are performed with multiple cycles of collection/draw phases and return/reinfusion phases. If the return/reinfusion phase does not include reinfusion of a replacement fluid, the donor's hematocrit will increase from one cycle to the next. Consequently, if the target volume for plasma product is determined based only on the donor's initial hematocrit, and does not take into account the donor's increasing hematocrit, the volume of anticoagulant in the plasma product will be greater (and the volume of raw plasma less) than what was predicted by the initial calculation for determining the target volume of plasma product. Thus, in order to ensure that the volume of plasma product that is collected contains the maximum volume of raw plasma that was determined to be harvested from a particular donor, the target volume for plasma product is recalculated periodically throughout the plasmapheresis procedure, such as before the start of the collection phase of each cycle, to take into account the change in the donors hematocrit.
Accordingly, a determination of the target volume for plasma product based on the donor's starting hematocrit is made. The plasmapheresis procedure commences with a first draw phase until a specified volume of whole blood (typically approximately 500 mL) has been withdrawn from the donor. Anticoagulant is added to the whole blood and the anticoagulated whole blood is separated into a plasma product, red blood cells, and other non-RBC blood components. At the conclusion of the first draw phase, the red blood cells and non-RBC blood components are returned to the donor. The current volume of plasma product collected after the first draw phase is determined by, e.g., the weigh scale. Then a current value for the hematocrit of the donor is established and a new target volume of plasma product to be collected is determined, and the second cycle of draw and return phases is performed. The cycle of draw and return phases is repeated until the target volume of plasma product tor the plasmapheresis procedure is collected, as recalculated prior to the start of each draw phase. After the final collection phase, the controller initiates the final red blood cell reinfusion stage, after which the donor is disconnected.
The benefits of performing a plasmapheresis procedure having multiple collection/reinfusion cycles in accordance with the methodology set forth above may be seen by reference to the tables of
The number of collection and reinfusion cycles in a plasmapheresis procedure may vary from three to twelve. In the hypothetical plasmapheresis procedure, there are five collection and reinfusion cycles, which are chosen for illustrative purposes.
Before the commencement of the first collection cycle, the volume of raw plasma to be collected and the total target volume of plasma product to be collected are determined in accordance with the methodologies described above, based on the donor's initial hematocrit. As set forth in the first row of the table (Cycle 1 start), the initial target volume for the plasma product to be collected is 889 mL, which is the same as indicated by the table of
During each collection phase, 500 mL of whole blood is drawn from the donor, to which anticoagulant is added at a predetermined ratio (i.e., 1:16), such that 31 mL is added for each collection cycle of 500 mL. The whole blood plus anticoagulant is separated into a plasma fraction and a red blood cell fraction.
During the first return phase (Cycle 1 return end), the red blood cells and “non-RBC” blood components are returned to the donor, so that at the end of the first return cycle the donor's hematocrit has increased to 45.6%, as calculated by the controller based on a blood volume being decreased by the amount of raw plasma collected, while the quantity of red blood cells in the total blood volume remains the same as at the start of the procedure. The controller can also account for the volume of anticoagulant that is reinfused in each return phase along with the red blood cells, as well as the residual anticoagulant in the donor's whole blood being drawn in cycles 2 and following, when determining the new hematocrit value for the next cycle. The volume of raw plasma and the total target volume of plasma product to be collected for the procedure are then recalculated based on the donor's new, increased hematocrit and raw plasma volume. This provides for a new total target collection volume of 891 mL.
The second collection phase is then performed, resulting in a total of 430 mL of plasma product comprising 386 mL of raw plasma being collected over the first two collection phases (Cycle 2 draw end). The red blood cells and “non-RBC” blood components are again returned to the donor, after which the donor's hematocrit is calculated to be 47.2%.
Two more collection phases of 500 mL are performed, each followed by a return phase, in which new values for the volume of raw plasma and total volume of plasma product to be collected are determined before the start of each collection phase. With the increasing hematocrit of the donor, the recalculated target collection volume for procedure increases to 893 mL (for the third collection phase) and then to 894 mL (for the fourth collection phase). A fifth “mini” collection cycle is performed to bring the volume of raw plasma collected up to the 800 mL permitted by the FDA nomogram for the hypothetical donor. The recalculated target collection volume of plasma product for the fifth collection phase remains at 894 mL.
Thus, as illustrated in the example above, when the target collection volume for the plasma product is recalculated for each collection phase, a target collection volume for the plasma product of 894 mL is obtained, which is required in order to collect the target volume of raw plasma of 800 mL. In contrast, 889 mL of plasma product would have been collected if the target collection volume is determined based only on the donor's initial hematocrit, or 880 mL if the target collection volume is based on the simplified FDA nomogram. In both cases, less than the target volume of 800 mL would have been collected.
As can be appreciated, the greater the accuracy with which the hematocrit of the donor can be determined, both before and during the procedure, the more likely the target volume of plasma product collected will include the maximum volume of raw plasma that can be collected for a particular donor. As described above, the hematocrit of the donor during the procedure is based on the assumptions that 100% of the red blood cells that are withdrawn in each draw cycle are reinfused in each return cycle, along with 100% of the non-RBC cellular products and a volume of anticoagulant. However, it has been determined that during the course of a blood separation procedure, interstitial fluid can shift to the intravascular space, resulting in restoring half of the withdrawn volume. See, Saito et al., Interstitial fluid shifts to plasma compartment during blood donation, Transfusion 2013; 53(11):2744-50. The shifted interstitial fluid is in addition to the red blood cells, non-RBC cellular products, and anticoagulant that are reinfused in each return phase. Thus, accounting for the shift of interstitial fluid would result in a more accurate hematocrit determination, and thus a more accurate determination of the target volume for plasma product that will result in the maximum amount of raw plasma.
The shift of interstitial fluid during plasmapheresis has been substantiated by tracking the level of Immunoglobulin G (IgG) of a donor over the course of a plasmapheresis procedure. See, e.g., Burkhardt et al., Immunoglobulin G levels during collection of large volume plasma for fractionation; Transfusion 2017; 56:417-420. If no interstitial fluid was being shifted, the IgG level of the donor would be stable over the course of the plasmapheresis procedure. However, the IgG level has been shown to drop, and the amount that the IgG level drops is a function of the volume of interstitial fluid that has shifted to the blood system.
With reference to
Based on the plot of
Alternatively, other methods that directly measure the donor's hematocrit may be employed, such as an optical sensor or, if a centrifugal separator is being used, measuring the volume of red blood cells in the centrifuge.
In addition, anticoagulant is commonly introduced into the disposable kit prior to the commencement of the plasmapheresis procedure in pre-processing steps, such as for priming the disposable kit, performing one or more pre-cycles, or for performing other pre-procedure steps. To the extent that anticoagulant used for these purposes is ultimately directed to the plasma product collection container, it may be accounted for in determining the volume contained in the plasma collection container that results in the target volume of raw plasma being collected. This may be done, for example, by measuring the weight of the “full” container of anticoagulant and the weight of the container of anticoagulant prior to the commencement of the first draw cycle, and adding that volume of anticoagulant to the target volume of plasma product. The controller can be configured to automatically perform the steps necessary to account for the anticoagulant introduced into the plasma collection container separately from the anticoagulated plasma.
The methods and system set forth above have several aspects. In a first aspect, a method for collecting plasma in which plasma product is collected in multiple collection phases between which separated red blood cells are reinfused to the donor is provided. The method of this first aspect comprises a) determining a volume of whole blood (Vb) and hematocrit (Hct) for a donor; b) determining a volume of raw plasma (VRP) that may be collected from the donor; c) determining a volume of plasma product (VPP) that may be collected, wherein the plasma product comprises the raw plasma volume plus a volume of anticoagulant; d) withdrawing whole blood from the donor; e) introducing anticoagulant into the withdrawn whole blood at a specified ratio (ACR); f) separating the withdrawn whole blood into a plasma product and a second component comprising red blood cells; g) collecting the plasma product in a plasma collection container; h) after a desired amount of whole blood has been withdrawn from the donor, returning the red blood cells to the donor; and i) determining the Hct of the donor and VPP prior to each collection phase.
In a second aspect, steps d)-i) are continued until a measured volume of plasma product in the collection container equals VPP.
In a third aspect, a method for collecting plasma in which plasma product is collected in multiple collection phases between which separated red blood cells are reinfused to the donor is provided. The method of this second aspect comprises: a) determining a volume of whole blood (Vb) and hematocrit (Hct) for a donor; b) determining a volume of raw plasma (VRP) that may be collected from the donor based on Vb; c) determining a volume of anticoagulant VAC to be added to the VRP based on an anticoagulant ratio (ACR) and the Hct of the donor, such that VAC=VRP*(ACR*(1−Hct)); d) determining a volume of plasma product (VPP) that may be collected, wherein the plasma product comprises the raw plasma volume (VRP) plus the volume of anticoagulant (VAC); e) withdrawing whole blood from the donor; f) introducing anticoagulant into the withdrawn whole blood at the specified ratio (ACR); g) separating the withdrawn whole blood into a plasma product and a second component comprising red blood cells; h) collecting the plasma product in a plasma collection container; i) after a desired amount of whole blood has been withdrawn from the donor, returning the red blood cells to the donor; and j) determining the Hct of the donor and VPP prior to each collection phase.
In a fourth aspect, steps d)-j) are continued until a measured volume of plasma product in the collection container equals VPP.
In a fifth aspect, Vb is determined based on one or more donor specific characteristics including a donor's weight, height, sex, age, and morphology.
In a fourth aspect, a method is provided for collecting a volume of plasma product (VPP) in an apheresis procedure in which plasma product is collected in multiple collection phases between which separated red blood cells are reinfused to the donor. In the method of this fourth aspect, VPP is equal to a volume of raw plasma (VRP) that may be collected from a donor plus a volume of anticoagulant (VAC) that is added to the VRP during the apheresis procedure. The steps of the method comprise: a) determining a weight (Wkg) and sex (M or F) for the donor; b) determining a hematocrit (Hct) for the donor; c) determining the volume of raw plasma (VRP) that may be collected based on the weight (Wkg) and sex (M or F) of the donor; d) determining a ratio K between the VPP and the VRP, such that K=VPPNRP, based on an anticoagulant ratio and the Hct of the donor; e) determining VPP, such that VPP=VRP*K; f) withdrawing whole blood from the donor; g) introducing anticoagulant into the withdrawn whole blood at a specified ratio (ACR); h) separating the withdrawn whole blood into a plasma product and a second component comprising red blood cells; i) collecting the plasma product in a plasma collection container; j) after a desired amount of whole blood has been withdrawn from the donor, returning the red blood cells to the donor; and k) determining the Hct of the donor and the target VPP prior to each collection phase.
In a fifth aspect, steps c)-k) are repeated until a measured volume of plasma product in the collection container equals VPP. Preferably, K=VPP/VRP=(ACR*(1−Hct/100)+1)/(ACR*(1−HCT/100)).
In a fifth aspect, a method is provided for collecting a volume of plasma product (VPP) in an apheresis procedure in which plasma product is collected in multiple collection phases between which separated red blood cells are reinfused to the donor. In this fifth aspect VPP is equal to a volume of raw plasma (VRP) that may be collected from a donor plus a volume of anticoagulant (VAc) that is added to the VRP during the apheresis procedure. The steps of the method comprise: a) determining a weight (Wkg) and sex (M or F) for the donor; b) determining a hematocrit (Hct) for the donor; c) determining the volume of raw plasma (VRP) that may be collected based on the weight of the donor (Wkg) and the sex (M or F) of the donor; d) determining the VAC to be added to the VRP based on an anticoagulant ratio (ACR) and the Hct of the donor, such that VAC=VPP*(ACR*(1−Hct)); e) determining VPP, such that VPP=VRP VAC; f) withdrawing whole blood from the donor; g) introducing anticoagulant into the withdrawn whole blood at a specified ratio (ACR); h) separating the withdrawn whole blood into a plasma product and a second component comprising red blood cells; i) collecting the plasma product in a plasma collection container; j) after a desired amount of whole blood has been withdrawn from the donor, returning the red blood cells to the donor; and k) determining the Hct of the donor and VPP prior to each collection phase.
In a sixth aspect, steps d)-k) are continued until a measured volume of plasma product in the collection container equals VPP.
In a seventh aspect, VRP is determined by establishing the VRP for each of a plurality of ranges of donor weight, and selecting the VRP for the range of weight that is inclusive of the weight of the donor. The ranges of donor weight may be in three categories from 110 to 149 lbs., 150 to 174 lbs., and 175 lbs. and up.
In an eighth aspect, VRP=K1*Wkg.
In a ninth aspect, VRP is no greater than 28.6% of (1−Hct)*(Vb).
In a tenth aspect, Vb is determined using one of Nadler's equations, Gilcher's Rule of Five, the standards of the ICSH, and any other generally accepted methodology.
In an eleventh aspect, VRP=Wkg*10 mL/kg.
In a twelfth aspect, when donor parameters are used to estimate a total blood volume (Vb) for the donor, VRP=K2*Vb.
In a thirteenth aspect, an automated system for separating plasma from whole blood is provided comprising a reusable hardware component and a disposable kit. The disposable kit further comprises i) a separator for separating whole blood into a plasma fraction and a concentrated cell fraction, the separator having an input having a blood line integrally connected thereto for transporting whole blood from a donor to the separator, a plasma output port integrally connected to a plasma collection container by a plasma line, and a concentrated cell outlet port integrally connected to a reservoir for receipt of concentrated cells prior to reinfusion to the donor; ii) a donor line terminating in a venipuncture needle for transporting whole blood from a donor to the blood line, iii) an anticoagulant line integrally connected to the blood line and configured to be connected to a source of anticoagulant for transporting anticoagulant to the donor line, iv) a saline line configured to be attached to a source of saline for transporting saline to the blood line, and v) a reinfusion line for transporting concentrated cells from the reservoir to the donor line. The reusable hardware component further comprises i) a first peristaltic pump for delivering anticoagulant at a controlled rate into the blood line during a collection phase, ii) a second pump for delivering anticoagulated whole blood to the separator during the collection phase and for returning concentrated cellular components during a reinfusion phase, iii) a third pump for delivering concentrated cellular components from the separator to the reservoir during the collection phase, iv) a clamp associated with each of the blood line, plasma line, reinfusion line and saline line, v) a weigh scale for weighing each of the plasma collection container, the reservoir and the source of anticoagulant, and vi) a programmable controller comprising a touch screen for receiving input from an operator, the programmable controller configured to receive a signal from each of the weigh scales and to automatically operate the first, second and third pumps and the clamps to separate whole blood into a plasma fraction and a concentrated cell fraction during the collection phase and to return concentrated cells to the donor during the reinfusion stage. The programmable controller is further configured to determine the weight of the plasma fraction to be collected in the plasma collection container in accordance with any of the aspects described herein, and to terminate the collection phase upon receiving a signal from the weigh scale for the plasma collection container equal to the weight of the plasma fraction determined by the controller. In determining the target amount for the plasma product to be collected, the controller may be configured to calculate the hematocrit of the donor prior to the collection phase of each cycle. Alternatively, or additionally, the controller may receive a signal from a sensor or the like that is indicative of the donor's hematocrit. Further, the amount of plasma product in the plasma collection container may be determined by, e.g., the weigh scale associated with the plasma collection. In one embodiment, the separator comprises a spinning membrane separator.
It will be understood that the embodiments described are illustrative of some of the applications of the principles of the present subject matter. Numerous modifications may be made by those skilled in the art without departing from the spirit and scope of the claimed subject matter, including those combinations of features that are individually disclosed or claimed herein. For these reasons, the scope of the claims is not limited to the above-description; but is set forth in the following claims.
This application is a continuation of prior application Ser. No. 17/825,918, filed May 26, 2022, which is a continuation of prior application Ser. No. 17/675,824, filed Feb. 18, 2022, now issued as U.S. Pat. No. 11,369,724, which is a continuation of prior application Ser. No. 17/386,992, filed Jul. 28, 2021, now issued as U.S. Pat. No. 11,285,251, which is a continuation of application Ser. No. 17/194,410, filed Mar. 8, 2021, now issued as U.S. Pat. No. 11,097,042, which is a continuation of prior application Ser. No. 17/062,368, filed Oct. 2, 2020, now issued as U.S. Pat. No. 10,946,131, which is a continuation of prior application Ser. No. 16/739,441, filed Jan. 10, 2020, now issued as U.S. Pat. No. 11,383,013, which is a continuation of International Application No. PCT/US2019/033318, filed May 21, 2019, which claims the benefit of U.S. Provisional Application No. 62/846,400, filed May 10, 2019, U.S. Provisional Application No. 62/752,480, filed Oct. 30, 2018 and U.S. Provisional Application No. 62/674,144, filed May 21, 2018, all of the above-referenced patent applications being incorporated by reference herein in their entireties.
Number | Name | Date | Kind |
---|---|---|---|
1025059 | Joseph et al. | Apr 1912 | A |
1611725 | Degerth et al. | Dec 1926 | A |
2087778 | Nelin | Jul 1937 | A |
2661150 | Abbott, Jr. | Dec 1953 | A |
2750107 | More | Jun 1956 | A |
2792172 | Tait | May 1957 | A |
3096283 | Hein | Jul 1963 | A |
3145713 | Latham | Aug 1964 | A |
3239136 | Hein | Mar 1966 | A |
3244362 | Hein | Apr 1966 | A |
3244363 | Hein | Apr 1966 | A |
3409213 | Latham | Nov 1968 | A |
3456875 | Hein | Jul 1969 | A |
3489145 | Judson et al. | Jan 1970 | A |
3565330 | Allen | Feb 1971 | A |
3655058 | Novak | Apr 1972 | A |
3737096 | Jones et al. | Jun 1973 | A |
3774840 | Boatright | Nov 1973 | A |
3987961 | Sinn et al. | Oct 1976 | A |
4007871 | Jones et al. | Feb 1977 | A |
4010894 | Kellogg et al. | Mar 1977 | A |
4014497 | Spiewok et al. | Mar 1977 | A |
4040965 | Kohlheb | Aug 1977 | A |
4056224 | Lolachi | Nov 1977 | A |
4082217 | Westberg | Apr 1978 | A |
4086925 | Dodge | May 1978 | A |
4140268 | Lacour | Feb 1979 | A |
4142670 | Ishimaru et al. | Mar 1979 | A |
4151844 | Almond et al. | May 1979 | A |
4197847 | Djerassi | Apr 1980 | A |
4285464 | Latham | Aug 1981 | A |
4300717 | Latham | Nov 1981 | A |
4303193 | Latham | Dec 1981 | A |
4321921 | Laszczower | Mar 1982 | A |
4387848 | Kellogg et al. | Jun 1983 | A |
4425114 | Schoendorfer et al. | Jan 1984 | A |
4430072 | Kellogg et al. | Feb 1984 | A |
4447221 | Mulzet | May 1984 | A |
4457747 | Tu | Jul 1984 | A |
4464167 | Schoendorfer et al. | Aug 1984 | A |
4466888 | Verkaart | Aug 1984 | A |
4482342 | Lueptow et al. | Nov 1984 | A |
4490135 | Troutner | Dec 1984 | A |
4530691 | Brown | Jul 1985 | A |
4534863 | Bacon et al. | Aug 1985 | A |
4643714 | Brose | Feb 1987 | A |
4647279 | Mulzet et al. | Mar 1987 | A |
4655742 | Vantard | Apr 1987 | A |
4680025 | Kruger et al. | Jul 1987 | A |
4684361 | Feldman et al. | Aug 1987 | A |
4692136 | Feldman et al. | Sep 1987 | A |
4708712 | Mulzet | Nov 1987 | A |
4713176 | Schoendorfer et al. | Dec 1987 | A |
4734089 | Cullis | Mar 1988 | A |
4740202 | Stacey et al. | Apr 1988 | A |
4740313 | Schoendorfer et al. | Apr 1988 | A |
4755300 | Fischel et al. | Jul 1988 | A |
4767396 | Powers | Aug 1988 | A |
4795419 | Yawn et al. | Jan 1989 | A |
4795448 | Stacey et al. | Jan 1989 | A |
4806247 | Schoendorfer et al. | Feb 1989 | A |
4806252 | Brown et al. | Feb 1989 | A |
4808307 | Fischel et al. | Feb 1989 | A |
4850995 | Tie et al. | Jul 1989 | A |
4869812 | Schoendorfer et al. | Sep 1989 | A |
4871462 | Fischel et al. | Oct 1989 | A |
4876013 | Shmidt et al. | Oct 1989 | A |
4889524 | Fell et al. | Dec 1989 | A |
4898675 | Lavender | Feb 1990 | A |
4911833 | Schoendorfer et al. | Mar 1990 | A |
4934995 | Cullis | Jun 1990 | A |
4940543 | Brown et al. | Jul 1990 | A |
4943273 | Pages | Jul 1990 | A |
4968295 | Neumann | Nov 1990 | A |
4980054 | Lavender | Dec 1990 | A |
4983156 | Knelson | Jan 1991 | A |
4983158 | Headley | Jan 1991 | A |
4985153 | Kuroda et al. | Jan 1991 | A |
4994188 | Prince | Feb 1991 | A |
5039401 | Columbus et al. | Aug 1991 | A |
5045048 | Kaleskas et al. | Sep 1991 | A |
5098372 | Jonsson | Mar 1992 | A |
5098373 | Polaschegg | Mar 1992 | A |
5100372 | Headley | Mar 1992 | A |
5100564 | Pall et al. | Mar 1992 | A |
5112298 | Prince et al. | May 1992 | A |
5114396 | Unger et al. | May 1992 | A |
5135667 | Schoendorfer | Aug 1992 | A |
5141486 | Antwiler et al. | Aug 1992 | A |
5147290 | Jonsson | Sep 1992 | A |
5154716 | Bauman et al. | Oct 1992 | A |
5174894 | Ohsawa et al. | Dec 1992 | A |
5178603 | Prince | Jan 1993 | A |
5194145 | Schoendorfer | Mar 1993 | A |
5217426 | Bacehowski et al. | Jun 1993 | A |
5217427 | Cullis | Jun 1993 | A |
5234403 | Yoda et al. | Aug 1993 | A |
5254248 | Nakamura | Oct 1993 | A |
5273517 | Barone et al. | Dec 1993 | A |
5277701 | Christie et al. | Jan 1994 | A |
5298016 | Gordon | Mar 1994 | A |
5298171 | Biesel | Mar 1994 | A |
5300060 | Nelson | Apr 1994 | A |
5316540 | Mcmannis et al. | May 1994 | A |
5318511 | Riquier et al. | Jun 1994 | A |
5318512 | Neumann | Jun 1994 | A |
5348533 | Papillon et al. | Sep 1994 | A |
5368542 | Mcmannis et al. | Nov 1994 | A |
5368555 | Sussman et al. | Nov 1994 | A |
5386734 | Pusinelli | Feb 1995 | A |
5387174 | Rochat | Feb 1995 | A |
5387187 | Fell et al. | Feb 1995 | A |
5403272 | Deniega et al. | Apr 1995 | A |
5405308 | Headley et al. | Apr 1995 | A |
5417650 | Gordon | May 1995 | A |
5431814 | Jorgensen | Jul 1995 | A |
5437598 | Delbert | Aug 1995 | A |
5437624 | Langley | Aug 1995 | A |
5462667 | Wollinsky et al. | Oct 1995 | A |
5470483 | Bene et al. | Nov 1995 | A |
5484396 | Naficy | Jan 1996 | A |
5494592 | Latham et al. | Feb 1996 | A |
5496265 | Langley et al. | Mar 1996 | A |
5505685 | Delbert | Apr 1996 | A |
5514070 | Pages | May 1996 | A |
5543062 | Nishimura | Aug 1996 | A |
5551941 | Howell | Sep 1996 | A |
5585007 | Antanavich et al. | Dec 1996 | A |
5607579 | Latham et al. | Mar 1997 | A |
5649903 | Deniega et al. | Jul 1997 | A |
5651766 | Kingsley et al. | Jul 1997 | A |
5656163 | Brown | Aug 1997 | A |
5665061 | Antwiler | Sep 1997 | A |
5681273 | Brown | Oct 1997 | A |
5686696 | Baker, Jr. et al. | Nov 1997 | A |
5712798 | Langley et al. | Jan 1998 | A |
5728060 | Kingsley et al. | Mar 1998 | A |
5733253 | Headley et al. | Mar 1998 | A |
5733446 | Holm | Mar 1998 | A |
5733545 | Hood, III | Mar 1998 | A |
5738792 | Schoendorfer | Apr 1998 | A |
5762791 | Deniega et al. | Jun 1998 | A |
5779660 | Kingsley et al. | Jul 1998 | A |
5783085 | Fischel | Jul 1998 | A |
5792351 | Wehrle et al. | Aug 1998 | A |
5849203 | Brown et al. | Dec 1998 | A |
5882289 | Sakota et al. | Mar 1999 | A |
5906589 | Gordon et al. | May 1999 | A |
5919125 | Berch | Jul 1999 | A |
5964724 | Rivera et al. | Oct 1999 | A |
5970432 | Ishimoto et al. | Oct 1999 | A |
5980760 | Min et al. | Nov 1999 | A |
6007725 | Brown | Dec 1999 | A |
6059979 | Brown | May 2000 | A |
6080322 | Deniega et al. | Jun 2000 | A |
6183651 | Brown et al. | Feb 2001 | B1 |
6200287 | Keller et al. | Mar 2001 | B1 |
6204694 | Sunter et al. | Mar 2001 | B1 |
6207063 | Brown | Mar 2001 | B1 |
6234989 | Brierton et al. | May 2001 | B1 |
6251284 | Bischof et al. | Jun 2001 | B1 |
6284142 | Muller | Sep 2001 | B1 |
6287818 | Kazimir et al. | Sep 2001 | B1 |
6296602 | Headley | Oct 2001 | B1 |
6325775 | Thom et al. | Dec 2001 | B1 |
6348156 | Vishnoi et al. | Feb 2002 | B1 |
6405508 | Janesky | Jun 2002 | B1 |
6464624 | Pages | Oct 2002 | B2 |
6471855 | Odak | Oct 2002 | B1 |
6497676 | Childers et al. | Dec 2002 | B1 |
6558307 | Headley | May 2003 | B2 |
6623443 | Polaschegg | Sep 2003 | B1 |
6641552 | Kingsley et al. | Nov 2003 | B1 |
6695806 | Gelfand et al. | Feb 2004 | B2 |
6730054 | Pierce et al. | May 2004 | B2 |
6730055 | Bainbridge et al. | May 2004 | B2 |
6743192 | Sakota et al. | Jun 2004 | B1 |
6746547 | Cole et al. | Jun 2004 | B2 |
6983884 | Auchlinleck | Jan 2006 | B2 |
7050611 | Bodicker et al. | May 2006 | B2 |
7072769 | Fletcher-Haynes et al. | Jul 2006 | B2 |
7115205 | Robinson et al. | Oct 2006 | B2 |
7186231 | Takagi et al. | Mar 2007 | B2 |
7270645 | Langley et al. | Sep 2007 | B2 |
7282154 | Muller | Oct 2007 | B2 |
7354415 | Bainbridge et al. | Apr 2008 | B2 |
7476209 | Gara et al. | Jan 2009 | B2 |
7704454 | Langley et al. | Apr 2010 | B1 |
8628489 | Pages et al. | Jan 2014 | B2 |
8702637 | Pages et al. | Apr 2014 | B2 |
8759094 | Ranby et al. | Jun 2014 | B2 |
8840790 | Wegener et al. | Sep 2014 | B2 |
9011359 | Wegener et al. | Apr 2015 | B2 |
9095665 | Pagès et al. | Aug 2015 | B2 |
9283316 | Flexman | Mar 2016 | B2 |
9302042 | Pages et al. | Apr 2016 | B2 |
9364600 | Pagès et al. | Jun 2016 | B2 |
9393359 | Boggs et al. | Jul 2016 | B2 |
10758652 | Ragusa | Sep 2020 | B2 |
10946131 | Patel | Mar 2021 | B2 |
10980934 | Ragusa | Apr 2021 | B2 |
11097042 | Patel | Aug 2021 | B2 |
11110216 | Patel et al. | Sep 2021 | B2 |
11285251 | Patel | Mar 2022 | B2 |
11369724 | Patel | Jun 2022 | B2 |
11383013 | Patel | Jul 2022 | B2 |
11386993 | Case | Jul 2022 | B2 |
11412967 | Patel | Aug 2022 | B2 |
20010000018 | Truong et al. | Mar 2001 | A1 |
20010027156 | Egozy et al. | Oct 2001 | A1 |
20020043492 | Bischof | Apr 2002 | A1 |
20020062100 | Pierce et al. | May 2002 | A1 |
20020120227 | Childers et al. | Aug 2002 | A1 |
20020151804 | O'mahony et al. | Oct 2002 | A1 |
20030055375 | Holst et al. | Mar 2003 | A1 |
20030066807 | Suzuki | Apr 2003 | A1 |
20030125017 | Greene et al. | Jul 2003 | A1 |
20030125881 | Ryan | Jul 2003 | A1 |
20030140928 | Bui et al. | Jul 2003 | A1 |
20030175150 | Grimm | Sep 2003 | A1 |
20040183683 | Funahashi | Sep 2004 | A1 |
20040186409 | Cavalcanti et al. | Sep 2004 | A1 |
20040199098 | Pierce et al. | Oct 2004 | A1 |
20050131334 | Langley et al. | Jun 2005 | A1 |
20050209522 | Tadokoro et al. | Sep 2005 | A1 |
20050228238 | Monitzer | Oct 2005 | A1 |
20050235733 | Holst et al. | Oct 2005 | A1 |
20050258238 | Chapman | Nov 2005 | A1 |
20060058167 | Ragusa et al. | Mar 2006 | A1 |
20060093190 | Cheng et al. | May 2006 | A1 |
20060155236 | Gara et al. | Jul 2006 | A1 |
20060226086 | Robinson et al. | Oct 2006 | A1 |
20070018832 | Beigel et al. | Jan 2007 | A1 |
20070067452 | Fung et al. | Mar 2007 | A1 |
20070112289 | Cavalcanti et al. | May 2007 | A1 |
20070138069 | Roncadi et al. | Jun 2007 | A1 |
20070258626 | Reiner | Nov 2007 | A1 |
20070268130 | Yee et al. | Nov 2007 | A1 |
20080146993 | Krishna | Jun 2008 | A1 |
20090215602 | Min et al. | Aug 2009 | A1 |
20090275808 | Dimaio et al. | Nov 2009 | A1 |
20100100392 | Rothman et al. | Apr 2010 | A1 |
20120010062 | Fletcher et al. | Jan 2012 | A1 |
20120053501 | Brown et al. | Mar 2012 | A1 |
20120175313 | Barry, Jr. et al. | Jul 2012 | A1 |
20130081998 | Chamney et al. | Apr 2013 | A1 |
20130267884 | Boggs et al. | Oct 2013 | A1 |
20140039373 | Ragusa et al. | Feb 2014 | A1 |
20140356851 | Pagès et al. | Dec 2014 | A1 |
20150367063 | Kimura | Dec 2015 | A1 |
20180344910 | Ragusa | Dec 2018 | A1 |
20180344921 | Ragusa | Dec 2018 | A1 |
20200345924 | Ragusa | Nov 2020 | A1 |
20210015989 | Patel et al. | Jan 2021 | A1 |
Number | Date | Country |
---|---|---|
2735985 | Oct 2005 | CN |
102046223 | May 2011 | CN |
102395392 | Mar 2012 | CN |
104800905 | Jul 2015 | CN |
204446748 | Jul 2015 | CN |
0128683 | Dec 1984 | EP |
0171749 | Feb 1986 | EP |
0208061 | Jan 1987 | EP |
0229504 | Jul 1987 | EP |
0257755 | Mar 1988 | EP |
0350162 | Jan 1990 | EP |
0578086 | Jan 1994 | EP |
0619145 | Oct 1994 | EP |
0654277 | May 1995 | EP |
0664159 | Jul 1995 | EP |
0799645 | Oct 1997 | EP |
0885619 | Dec 1998 | EP |
1057534 | Dec 2000 | EP |
1295619 | Mar 2003 | EP |
1374927 | Jan 2004 | EP |
2650030 | Oct 2013 | EP |
2258898 | Oct 1977 | FR |
2017110 | Oct 1979 | GB |
S596952 | Jan 1984 | JP |
S5969166 | Apr 1984 | JP |
H0252665 | Feb 1990 | JP |
H03131268 | Jun 1991 | JP |
H0775746 | Mar 1995 | JP |
H08131539 | May 1996 | JP |
H09192215 | Jul 1997 | JP |
2002282352 | Oct 2002 | JP |
2002291872 | Oct 2002 | JP |
3936132 | Jun 2007 | JP |
2008506424 | Mar 2008 | JP |
2252788 | May 2005 | RU |
660718 | May 1979 | SU |
762982 | Sep 1980 | SU |
1146098 | Mar 1985 | SU |
8502561 | Jun 1985 | WO |
9000059 | Jan 1990 | WO |
9007383 | Jul 1990 | WO |
9406535 | Mar 1994 | WO |
9611747 | Apr 1996 | WO |
9633023 | Oct 1996 | WO |
0205059 | Jan 2002 | WO |
2007041716 | Apr 2007 | WO |
2018222441 | Dec 2018 | WO |
2019084278 | May 2019 | WO |
Entry |
---|
Altunatas, F., et al., Comparison of Plateletpheresis on the Fenwal Amicus and Fresenius Com.Tec Cell Separators, Transfusion Medicine and Hemotherapy, vol. 35, pp. 368-373, 2008. |
Amendment and Argument filed on Aug. 6, 2021 in Korean Application No. 10-2020-7033247 with English translation (11 pages.). |
Amendment and Argument filed on Dec. 15, 2021 in Japanese Application No. 2020202093 with English translation (12 pages.). |
Amendment and Reply in U.S. Appl. No. 16/739,441 dated Apr. 5, 2022, 13 pages. |
Amendment filed in U.S. Appl. No. 17/306,099, dated Nov. 2, 2021, 17 pages. |
Amendment in U.S. Appl. No. 17/306,099 dated Apr. 5, 2022, 18 pages. |
Amendment to the application with English translation for Korean Patent Application No. 10-2020-7033175 dated May 24, 2021 (11 pages). |
Amendment to the application with English translation for Korean Patent Application No. 10-2020-7033247 dated May 24, 2021 (40 pages). |
Anonymous, 21 CFR Parts 606, 610, 630, et I.; Requirements for Blood and Blood Components Intended for Transfusion or for Further Manufacturing Use; Final Rule, Federal Register, vol. 80, 2015. |
Anonymous, Code of Federal Regulations, §606.110 General donor eligibility requirements, Code of Federal Regulations, National Archives, May 2020. |
Anonymous, Code of Federal Regulations, §630.10 General donor eligibility requirements, Code of Federal Regulations, National Archives, May 2020. |
Anonymous, Code of Federal Regulations, §630.15 Donor eligibility requirements, Code of Federal Regulations, National Archives, May 2020. |
Anonymous, Code of Federal Regulations, §640.65 Plasmapheresis, Code of Federal Regulations, National Archives, pp. 105-107, Apr. 2020. |
Applicant-Initiated Interview Summary, U.S. Appl. No. 17/306,099, dated Nov. 5, 2021, 17 pages. |
Bialkowski W., et al., Citrate anticoagulation: Are blood donors donating bone?, Journal of clinical apheresis, United States, vol. 31, pp. 459-463, Oct. 2016. |
Blaha, M. et al., Experience with extracorporeal elimination therapy in myasthenia gravis, Transfusion and Apheresis Science Elsevier Scienct, London, GB, vol. 45, pp. 252-256, 2011. |
Burgstaler, E. A., Blood component collection by apheresis, Journal of clinical apheresis, United States, Journal of clinical apheresis, United States, vol. 21, pp. 142-151, Jul. 2006. |
Burgstaler, E.A., et al., Paired comparison of therapeutic plasma exchange using the Fenwal Amicus versus TerumoBCT Spectra Optia, Journal of clinical apheresis, United States, vol. 33, pp. 265-273, Jun. 2018. |
Canadian Requisition by the Examiner in Accordance with Subsection 86(2) of the Patent Rules dated Sep. 28, 2021 for Canadian Application No. 3,099,428. |
Caridian BCT; Operator's Manual: Trima Accel® Automated Blood Collection System for Version 6.0 with Automated RBC Processes; Part No. 777095-197, Jun. 2010, (296 pages). |
Charifa, A. et al., Transfusion medicine equations made internet accessible, American Journal of Clinical Pathology Oct. 10, 2018, Oxford University Press, vol. 150, Oct. 2018. |
China National Intellectual Property Administration Notification of the First Office Action dated Dec. 6, 2021 for Chinese International Application No. 201980031598.1. |
Colpo, A., et al., Therapeutic apheresis during pregnancy: A single center experience, Transfusion and Apheresis Science, Elsevier Science, London, GB, Sep. 5, 2019. |
Communication pursuant to Article 94(3) EPC, App. No. 21198088.3, dated Jun. 13, 2022, 6 pages. |
Compliance Program Guidance Manual, Chapter 42—Blood and Blood Components, Inspection of Source Plasma Establishments, Brokers,Testing Laboratories, and Contractors—7342.002, Completion Date: Jan. 31, 2019, (63 pages). |
Cordts, P.R. et al., Poor predictive value of hematocrit and hemodynamic parameters for erythrocyte deficits after extensive elective vascular operations, Surgery, gynecology & obstetrics, United States, vol. 175, pp. 243-248, Sep. 1992. |
De Back, D. Z. et al.,Therapeutic plasma apheresis: Expertise and indications, Transfusion and Apheresis Science, vol. 58, pp. 254-257, Jun. 2019. |
Director, Center for Biologies Evaluation and Research, Volume Limits—Automated Collection of Source Plasma, FDA, Nov. 4, 1992 (3 pgs.). |
Evers, D. et al., The efficiency of therapeutic erythrocytapheresis compared to phlebotomy: a mathematical tool for predicting response in hereditary hemochromatosis, polycythemia vera, and secondary erythrocytosis, Journal of clinical apheresis, United States, vol. 29, pp. 133-138, Jun. 2014. |
Evers, J. et al., Distribution of citrate and citrate infusion rate during donor plasmaphereses, Journal of clinical apheresis, United States, vol. 31, pp. 59-62, Feb. 2016. |
Examination report No. 1 for standard patent application for Australian patent No. 2019274489 dated Nov. 16, 2020 (4 pages). |
Examination report No. 1 for standard patent application for Australian patent No. 2020267188 dated Nov. 25, 2020 (7 pages). |
Examiner Requisition in Canada App. 3,099,428 dated Mar. 28, 2022, 4 pages. |
Extended European Search Report dated Nov. 8, 2021 for European Application No. 21183088.0. |
Extended European Search Report, counterpart EP Application No. 21168049.1 (dated Aug. 17, 2021) (8 pages). |
Feldschuh, J. et al., Prediction of the Normal Blood Volume Relation of Blood Volume to Body Habitus, Circulation 1977, vol. 56, pp. 605-612, Oct. 1977. |
Feldschuh, J. et al., The importance of correct norms in blood volume measurement, The American journal of the medical sciences, United States, vol. 334, pp. 41-46, Jul. 2007. |
Fenwal: AMICUSTM Separator: Operator's Manual SW v. 4.3; Ref 4R4580, 4R4580R, Jun. 2011, (501 pages). |
Fenwal: AMICUSTM Separator: Therapeutics Supplement Manual SW v. 4.2, Mononuclear Cell Collection + Therapeutic Plasma Exchange; Ref 4R4580, 4R4580R, Apr. 2011, (372 pages). |
Fenwal: AMICUSTM Separator: Therapeutics Supplement Manual SW v. 4.3, Mononuclear Cell Collection + Therapeutic Plasma Exchange; Ref 4R4580, 4R4580R, Mar. 2012, 372 pages. |
Fresenius Kabi: AMICUS Separator: Operator's Manual SW v. 5.1, vol. 2—Platelets with Concurrent Plasma or RBC Collection, Ref 4R4580, 4R4580R, 4R4580TH, 6R4580, 6R4560R, Mar. 2017, 352 pages. |
Fresenius Kabi: AMICUS Separator: Operator's Manual SW v. 5.1, vol. 2—Platelets with Concurrent Plasma or RBC Collection, REF4R4580, 4R4580R, 4R4580TH, 6R4580, 6R4580R, Mar. 2017, 352 pages. |
Gokay, S. et al., Long-term efficacy of lipoprotein apheresis in the management of familial hypercholesterolaemia: Application of two different apheresis techniques in childhood, Transfusion and Apheresis Science, Elsevier Science, London, GB, vol. 54, pp. 282-288, Nov. 2, 2012. |
Hadem, J. et al., Therapeutic plasma exchange as rescue therapy in severe sepsis and septic shock: retrospective observational single-centre study of 23 patients, BMC Anesthesiology, Biomed Central, London, GB, vol. 14, p. 24, Apr. 2014. |
Hafer, C. et al., Membrane versus centrifuge-based therapeutic plasma exchange: a randomized prospective crossover study, International urology and Nephrology, Akademiai, Budapest, HU, vol. 48, pp. 133-138, Nov. 3, 2015. |
Hafer, C. et al., Pro: High dose of therapeutic plasma exchange—mind the gap!, Nephrology, dialysis, transplantation official publication of the European Dialysis and Transplant Association—European Renal Association England; vol. 32, pp. 1457-1460, Sep. 1, 2017. |
Hattersley, J.G. et al., Describing the effectiveness of immunosuppression drugs and apheresis in the treatment of transplant patients, Computer Methods and Programs In Biomedicine, Amsterdam, NL, vol. 109, pp. 126-133, Feb. 10, 2012. |
Hauser, R. G. et al., Transfusion Medicine Equations Made Internet Accessible, Transfusion Medicine Reviews, Nov. 16, 2019 Grune and Stratton, Orlando, FL, US, vol. 34, Nov. 2019. |
International Search Report and Written Opinion dated Dec. 1, 2021 for International Application No. PCT/US2021/047124. |
International Search Report and Written Opinion dated Sep. 30, 2021 for International Application No. PCT/JS21/33835. |
International Search Report and Written Opinion for Application No. PCT/US2018/033826, dated Aug. 3, 2018, 10 pages. |
International Search Report and Written Opinion for Application No. PCT/US2018/57528, dated Jan. 7, 2019, 17 pages. |
International Search Report and Written Opinion, counterpart International App. No. PCT/US2021/033835 (dated Sep. 30, 2021) (20 pages). |
International Search Report and Written Opinion, counterpart International Appl. No. PCT/US2019/033318 (dated Aug. 21, 2019) (14 pages). |
Jia, Z.S. et al., Total blood volume of Asian patients undergoing cardiac surgery is far from that predicted by conventional methods, The Journal of cardiovascular surgery, Italy, vol. 54, pp. 423-430, Jun. 2013. |
Kawai, Y. et al., Therapeutic plasma exchange may improve hemodynamics and organ failure among children with sepsis-induced multiple organ dysfunction syndrome receiving extracorporeal life support, Pediatric critical care medicine: a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, United States, vol. 16, pp. 366-374, May 2015. |
Keklik, M. et al., Effectiveness of the haemonetics MCS cell separator in the collection of apheresis platelets, Transfusion and Apheresis Science Elsevier Science, London, GB, vol. 53, pp. 396-398, Aug. 2015. |
Kochinke, F. et al., Modelling of LDL-apheresis: System efficacy and rebound kinetics, Plasma Therapy and Transfusion Technology, vol. 9, pp. 35-44, 1988. |
Kuan, Jew-Win et al., A randomized double blind control trial comparing filgrastim and pegfilgrastim in cyclophosphamide peripheral blood hematopoietic stem cell mobilization, Transfusion and Apheresis Science Elsevier Science, London, GB, vol. 53, pp. 196-204, Mar. 2015. |
Kube{hacek over (c)}ek, O. et al., Plasmafiltration as an effective method in the removal of circulating pegylated liposomal doxorubicin (PLD) and the reduction of mucocutaneous toxicity during the treatment of advanced platinum-resistant ovarian cancer, Cancer Chemotherapy and Pharmacology, Springer Verlag, Berlin, DE, vol. 85, pp. 353-365, Nov. 14, 2019. |
Lambert, C. et al., Plasma extraction rate and collection efficiency during therapeutic plasma exchange with Spectra Optia in comparison with Haemonetics MCS+, Journal of clinical apheresis, United States, vol. 26, pp. 17-22, 2011. |
Lemmens, H. et al., Estiimating Blood Volume in Obese and Morbidly Obese Patients, Obesity Surgery, vol. 16, pp. 773-776, 2006. |
Lin, Shi-Woei et al., Optimal collecting policy for apheresis platelets in a regional blood center, Vox Sanguinis, vol. 115, Feb. 2020. |
Linderkamp, O. et al., Estimation and Prediction of Blood Volume in Infants and Children, European Journal of Pediatrics, vol. 125, pp. 227-234, Aug. 1977. |
Lopez, A.J., et al., Monitoring and isolation of blood dendritic cells from apheresis products in healthy individuals: a platform for cancer immunotherapy, Journal of Immunological Methods, Sep. 15, 2002 Elsevier Science Publishers B. V., Amsterdam, NL, vol. 267, pp. 199-212, Sep. 2002. |
Lopez, A.J., et al., Monitoring and isolation of blood dendritic cells from apheresis products in healthy individuals: a platform for cancer immunotherapy, Journal of Immunological Methods, Sep. 9, 2002 Elsevier Science Publishers B.V., Amsterdam, NL, vol. 267, pp. 199-212, Sep. 2002. |
Maitta, Robert W., Current state of apheresis technology and its applications, Transfusion and Apheresis Science, vol. 57, pp. 606-613, Oct. 2018. |
Merolle, L., et al.,The effect of donor's characteristics on plasmapheresis products: insights for a personalised approach Blood transfusion = Trasfusione del sangue, Italy, May 2020. |
Miladi, M.I. et al., Relevance of plasma exchange in the treatment of myasthenia gravis: Study of 11 cases, Revue de Medecine Interne Feb. 2008, France, vol. 29, pp. 87-93. |
Milan, B. et al., Experience with extracorporeal elimination therapy in myasthenia gravis, Transfusion and Apheresis Science Elsevier Scienct, London, GB, vol. 45, pp. 252-256, 2011. |
Neff, L.P., The use of theraputic plasma exchange (TPE) in the setting of refractory burn shock, Bums 2010 Elsevier Ltd., vol. 36, pp. 372-378, 2010. |
Neyrinck, M.M. et al., Calculations in apheresis, Journal of clinical apheresis, vol. 30, pp. 38-42, Feb. 2015. |
Notice for Reasons for Refusal in Japan App. 2020-202093 dated Jan. 11, 2022, 3 pages. |
Notice of Allowance in U.S. Appl. No. 17/386,992 dated Feb. 9, 2022, 8 pages. |
Notice of Preliminary Rejection with English translation for Korean Patent Application No. 10-2020-7033175 dated Mar. 22, 2021 (13 pages). |
Notice of Preliminary Rejection with English translation for Korean Patent Application No. 10-2020-7033247 dated Mar. 22, 2021 (31 pages). |
Notice of Reasons of Refusal with English translation, counterpart Japanese application 2020-202093 dated Jun. 15, 2021 (8 pages). |
Notice of Reasons of Refusal with English translation, counterpart Japanese application 2020-557304 dated May 11, 2021 (8 pages). |
Office communication in U.S. Appl. No. 17/078,824 dated Nov. 3, 2021, 22 pages. |
Office communication in U.S. Appl. No. 17/306,099 dated Dec. 6, 2021, 17 pages. |
Office communication in U.S. Appl. No. 17/306,099 dated Sep. 23, 2021, 19 pages. |
Pearson, T.C. et al., Interpretation of measured red cell mass and plasma volume in adults: Expert Panel on Radionuclides of the International Council for Standardization in Haematolog, British journal of haematology, England, vol. 89, pp. 748-756, Apr. 1995. |
Perry, F.A. et al., Blood volume replacement in surgical patients; Surgical Clinics of North America, pp. 301-313, Apr. 1956. |
Pratx, L.B. et al., Development of apheresis techniques and equipment designed for patients weighing less than 10 kg, Transfusion and Apheresis Science, vol. 57, pp. 331-336, Jun. 2018. |
Request for Examination in EP21168049 dated Mar. 29, 2022, 12 pages. |
Response to Examiner's Report for Australian Patent Application 2019274489 dated Mar. 16, 2021 (12 pages) (12 pages). |
Response to Examiner's Report for Australian Patent Application 2020267188 dated Mar. 16, 2021 (12 pages) (20 pages). |
Response to Non-Final Office Action in U.S. Appl. No. 17/078,824 dated Apr. 4, 2022, 11 pages. |
Response to Notice of Preliminary Rejection with English translation for Korean Patent Application No. 10-2020-7033175 dated May 24, 2021 (33 pages). |
Response to Notice of Preliminary Rejection with English translation for Korean Patent Application No. 10-2020-7033247 dated May 24, 2021 (42 pages). |
Russian Patent Office, Russian Search Report for RU2252788C1 with English translation dated Jun. 2, 2021 (4 pages). |
Schertler, V. et al., How to optimize lipoprotein apheresis treatment—A second look, Atherosclerosis Supplements, vol. 14, pp. 89-92, Jan. 2013. |
Schwartz, J. et al., Guidelines on the use of therapeutic apheresis in clinical practice-evidence-based approach from the Writing Committee of the American Society for Apheresis: the sixth special issue, Journal of clinical apheresis, United States, vol. 28, pp. 145-284, Jul. 2013. |
Schwartz, J. et al., Guidelines on the Use of Therapeutic Apheresis in Clinical Practice-Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Seventh Special Issue, Journal of clinical apheresis, United States, vol. 31, pp. 149-162, Jun. 2016. |
Setia, R.D. et al., Comparison ofAmicus and COBE Spectrafor allogenic peripheral blood stem cell harvest: Study from tertiary care centre in India, Transfusion and Apheresis Science, Elsevier Science, London, GB, vol. 56, pp. 439-444, Apr. 24, 2017. |
Simsir, I.Y. et al., Therapeutic plasmapheresis in thyrotoxic patients, Endocrine, Humana Press, Inc, US, vol. 62, pp. 144-148, Jul. 2, 2018. |
Sprenger, K.B., Nomograms for the prediction of patients plasma volume in plasma exchange therapy from height, weight, and hematocrit, Journal of clinical apheresis, United States, vol. 3, pp. 185-190, Jan. 1987. |
Staley, E. M. et al., A brief review of common mathematical calculations in therapeutic apheresis, Journal of clinical apheresis, United States, vol. 34, pp. 607-612, Oct. 2019. |
Technical Manual 20th edition, Methods and Appendices, http://www.aabb.org/programs/publications/Pages/tech-manual-methods.aspx, 2020. |
Trima Accel Automated Blood Collection System Service Manual, pp. 1-340 (2015). |
Valbonesi, A.M. et al., Plateletpheresis: What's new?, Transfusion Science, Dec. 1, 1996 Pergamon Press, Oxford, GB, vol. 17, pp. 537-544, Dec. 1996. |
Vassallo, R.R et al., Improved donor safety in high-volume apheresis collections, Transfusion Feb. 1, 2017 Blackwell Publishing Inc., USA, vol. 57, pp. 319-324, Feb. 2017. |
Vurro, F. et al., Quantitative assessment of the anticoagulant in plasma units collected by plasmapheresis, Transfusion (Malden), vol. 59, pp. 2113-2120, Jun. 2019. |
Way, B. et al., Inova blood donor center experience with Trima Accel 7, Transfusion Sep. 1, 2019 Blackwell Publishing Inc., vol. 59, pp. 48A-49A, Sep. 2019. |
Williams, A.E., FDA Considerations Regarding Frequent Plasma Collection Procedures, www.ihn-org.com, 2013. |
Winters, J.L. et al., American Society for Apheresis guidelines on the use of apheresis in clinical practice: practical, concise, evidence-based recommendations for the apheresis practitioner, Journal of clinical apheresis, United States, vol. 29, pp. 191-193, Aug. 2014. |
Partial Translation of First Examination Report in Saudi Arabia Patent Application 520420610 based on PCT/WO/us2019/03338, 2 pages. |
Response to Subsection 86(2) Requisition in Canada Aoo No. 3099428 dated Jan. 27, 2022, 24 pages. |
PCT International Search Report and Written Opinion in App. No. PCT/US 22/27484 dated May 3, 2022, 15 pages. |
Response to communication dated Jun. 13, 2022 in European Patent Application 211198088.3, 30 pages. |
Requisition in Canada App. No. 3,099,428 dated Nov. 14, 2022, 5 pages. |
Response to Subsection 86(2) Requisition in Canada App. No. 3,099,428 dated Mar. 14, 2023, 52 pages. |
Maikowski & Ninnemann letter in European application 21168049.1, dated Mar. 29, 2022. |
Number | Date | Country | |
---|---|---|---|
20230181807 A1 | Jun 2023 | US |
Number | Date | Country | |
---|---|---|---|
62674144 | May 2018 | US | |
62752480 | Oct 2018 | US | |
62846400 | May 2019 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 17825918 | May 2022 | US |
Child | 18109547 | US | |
Parent | 17675824 | Feb 2022 | US |
Child | 17825918 | US | |
Parent | 17386992 | Jul 2021 | US |
Child | 17675824 | US | |
Parent | 17194410 | Mar 2021 | US |
Child | 17386992 | US | |
Parent | 17062368 | Oct 2020 | US |
Child | 17194410 | US | |
Parent | 16739441 | Jan 2020 | US |
Child | 17062368 | US | |
Parent | PCT/US2019/033318 | May 2019 | US |
Child | 16739441 | US |