Pentastarch 6% / Sodium chloride 0.9% infusion 500ml bags

Intracoronary optical coherence tomography (OCT) requires injection of flushing media for image acquisition. Alternative flushing media needs to be investigated to reduce the risk of contrast-induced renal dysfunction. We investigated the feasibility and safety of pentastarch (hydroxyethyl starch) for clinical OCT imaging. We prospectively enrolled 43 patients with 70 coronary lesions (46-stented; 24-native). Total 81 OCT pullback pairs were obtained by manual injection of iodine contrast, followed by pentastarch. Each pullback was assessed frame-by-frame using an automated customized lumen contour/stent strut segmentation algorithm. Paired images were compared for the clear image segments (CIS), blood-flushing capability, and quantitative morphometric measurements. Overall image quality, as assessed by the proportion of CIS, was comparable between the contrast- and pentastarch-flushed images (97.1% vs. 96.5%; p = 0.160). The pixel-based blood-flushing capability was similar between the groups (0.951 [0.947-0.953] vs. 0.950 [0.948-0.952], p = 0.125). Quantitative two- and three-dimensional morphometric measurements of the paired images correlated well (p < 0.001) with excellent inter-measurement variability. All patients safely underwent OCT imaging using pentastarch without resulting in clinically relevant complications or renal deterioration. Non-contrast OCT imaging using pentastarch is clinically safe and technically feasible with excellent image quality and could be a promising alternative strategy for patients at high risk of renal impairment.

Abstract licence: CC BY

A BSTRACT Background and Objectives: Dimethylsulfoxide(DMSO) is gold standard for cryopreservation of hematopoietic progenitor cells (HPC) to reconstitute hematopoiesis in autologous stem cell transplants (auto-HSCT). Higher DMSO-related adverse effects (AEs) are reported in pediatric patients due to lower body weight with the recommended maximal dose of 1g/kg bodyweight. This study compares adding Hhydroxyethyl starch Vs Pentastarch to DMSO in order to reduce the DMSO related adverse effects. Adding a non-permeating cryoprotectant like Hydroxyethyl starch (HES) lowers DMSO concentration. HES is known to cause pruritus and nephrotoxicity. Pentastarch has lower molecular weight hence faster renal elimination with fewer reported AEs. Adding a non-permeating cryoprotectant like Hydroxyethyl starch (HES) lowers DMSO concentration. Methods: This study is a single-centre retrospective-comparative analysis from October 2022 to February 2024, comparing cryopreservation outcomes using standard cryoprotectant-DMSO+ HES+albumin solution (CPS-1) with pentastarch+albumin+DMSO solution (CPS-2). During the study period, 20 pediatric patients who underwent auto-HSCT requiring cryopreserved HPC-A were included. Results: Average CD34+ recovery with CPS-1 and CPS-2 were 86.58±13.42 and 87.5±13.2% (P-value=0.879). Median time to neutrophil engraftment was comparable (10 days) and no significant difference in platelet engraftment was observed, median 13.5 and 15 days with CPS-1 and CPS-2. Post-cryopreservation product volume was lesser with CPS-2 compared to CPS-1 (271±34.77ml and 78±24.7; P&lt; 0.0001). Mean DMSO volume in CPS-2 was significantly lower than in CPS-1 (7.5±2.63ml and 13.55±1.83ml; P&lt;0.0001). AEs were lesser with CPS-2 than CPS-1 (P = 0.178), and most patients with AEs were &lt;25kg. Reducing volume of DMSO infusion with CPS-2 decreased AEs without impairing hematopoietic function of the HPC graft. Conclusion: Pentastarch containing freezing solution appears to be suitable for pediatric auto-HSCT cases, especially with body weight&lt;25kgs offering additional advantage in case of patients with renal impairment.

Abstract licence: CC BY-NC-SA