Yıl 2018, Cilt 4, Sayı 4, Sayfalar 343 - 348 2018-10-04

Therapeutic plasmapheresis: an eleven-year clinical experience

Yasemin Tekdöş Şeker [1] , Gülsüm Oya Hergünsel [2] , Deniz Özel Bilgi [3]

61 145

Objective: Therapeutic plasma exchange (TPE) is currently indicated as an alternative treatment regimen in a number of guidelines for various medical conditions. In this article we retrospectively reviewed cases who underwent TPE in Bakırköy Dr. Sadi Konuk Training and Research Hospital intensive care unit between 2007 and 2016 and compared the findings to the current reports in the literature.

Methods: A total of 80 cases were treated with TPE between 2007 and 2016 in our intensive care unit. Information on demographic variables, therapeutic indications, catheterized veins, complications during the procedure, number of sessions, replacement products used and survival data was collected. In addition, pre- and post-procedure serum triglyceride, cholesterol and amylase levels were also collected in acute pancreatitis cases associated with hypertriglyceridemia.

Results: A total of 501 TPE sessions were performed on 80 cases comprising 35 neurology, 18 hematology, 12 hypertriglycemic acute pancreatitis and 7 acute hepatic insufficiency patients, along with 8 cases with less common indications including sepsis, hyperthyroidism resistant to medical therapy and toxic epidermal necrolysis. The age of the subjects ranged between 12 and 82 years (mean; 45.08 ± 14.67 years). Sixteen (23.19%) cases died before the completion of the planned sessions. Pre- and post-procedure serum triglyceride, cholesterol and amylase levels were significantly different in acute pancreatitis cases (p < 0.05).

Conclusion: Timely implementation of TPE in applicable indications may be helpful in preventing morbidity and mortality in a wide spectrum of disorders. 

plasmapheresis, plasma exchange, pancreatitis, Guillain barre syndrome, intensive care unit
  • [1] McLeod BC. Plasma and plasma derivatives in therapeutic plasmapheresis. Transfusion 2012;52( Suppl 1):38S-44S.
  • [2] Schwartz J, Padmanabhan A, Aqui N, Balogun RA, Connelly-Smith L, Delaney M, 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. J Clin Apher 2016;31:149-62.
  • [3] Wozniak K, Urbanowska E, Snarski E. [Plasmapheresis in haematology]. Wiad Lek 2015;68:173-8. [Article in Polish]
  • [4] Lainez-Andres JM, Gascon-Gimenez F, Coret-Ferrer F, Casanova-Estruch B, Santonja JM. [Therapeutic plasma exchange: applications in neurology]. Rev Neurol 2015;60:120-31. [Article in Spanish]
  • [5] Matsumoto M. New developments in treatment modalities of thrombotic thrombocytopenic purpura. Rinsho Ketsueki 2017;58:2081-6.
  • [6] Stefanutti C, Morozzi C, Petta A. Lipid and low-density-lipoprotein apheresis. Effects on plasma inflammatory profile and on cytokine pattern in patients with severe dyslipidemia. Cytokine 2011;56:842-9.
  • [7] Saito A. Current progress in blood purification methods used in critical care medicine. Contrib Nephrol 2010;166:100-11.
  • [8] Golestaneh L, Mokrzycki MH. Vascular access in therapeutic apheresis: update 2013. J Clin Apher 2013;28:64-72.
  • [9] Stegmayr B, Wikdahl AM. Access in therapeutic apheresis. Ther Apher Dial 2003;7:209-14.
  • [10] Nguyen TC, Han YY. Plasma exchange therapy for thrombotic microangiopathies. Organogenesis 2011;7:28-31.
  • [11] Rimmer E, Houston BL, Kumar A, Abou-Setta AM, Friesen C, Marshall JC, et al. The efficacy and safety of plasma exchange in patients with sepsis and septic shock: a systematic review and meta-analysis. Crit Care 2014;18:699.
  • [12] Pruijm MT, Cherpillod A, Vogt B, Burnier M. [Plasmapheresis: technique, complications and indications]. Rev Med Suisse 2008;4:581-2, 584-6, 588. [Article in French]
  • [13] Stevenson ME, Leung N, Winters JL. What are the newer applications for therapeutic apheresis in Nephrology?: Current Indications for Therapeutic Plasma Exchange in Nephrology. Semin Dial 2016;29:350-3.
  • [14] Sutton DM, Nair RC, Rock G. Complications of plasma exchange. Transfusion 1989;29:124-7.
  • [15] Cortese I, Cornblath DR. Therapeutic plasma exchange in neurology: 2012. J Clin Apher 2013;28:16-9.
  • [16] Nomura K. [Treatment of Guillain-Barre Syndrome]. Brain Nerve 2015;67:1397-410. [Article in Japanese]
  • [17] Kulkantrakorn K, Sukphulloprat P. Outcome of Guillain-Barre Syndrome in tertiary care centers in Thailand. J Clin Neuromuscul Dis 2017;19:51-6.
  • [18] Tombak A, Ucar MA, Akdeniz A, Yilmaz A, Kaleagasi H, Sungur MA, et al. Therapeutic plasma exchange in patients with neurologic disorders: review of 63 cases. Indian J Hematol Blood Transfus 2017;3397-105.
  • [19] Hassan A, Yasawy ZM. Myasthaenia Gravis: clinical management issues before, during and after pregnancy. Sultan Qaboos Univ Med J 2017;17:e259-67.
  • [20] Deguchi K, Matsuzono K, Nakano Y, Kono S, Sato K, Deguchi S, et al. A case of anti-MuSK antibody-positive myasthenia gravis successfully treated with outpatient periodic weekly blood purification therapy. Intern Med. 2018. doi: 10.2169/internalmedicine.9466-17.
  • [21] Prakash S, Hans R, Sharma RR, Lal V, Marwaha N. Therapeutic plasma exchange in a patient of myasthenic crisis, refractory to intravenous immunoglobulin and immunosuppressive therapy. Neurol India 2017;65:1409-12.
  • [22] Niewold TB, Bundrick JB. Disseminated intravascular coagulation due to cytomegalovirus infection in an immunocompetent adult treated with plasma exchange. Am J Hematol 2016;81:454-7.
  • [23] Winters JL. Plasma exchange in thrombotic microangiopathies (TMAs) other than thrombotic thrombocytopenic purpura (TTP). Hematology Am Soc Hematol Educ Program 2017;2017:632-8.
  • [24] Click B, Ketchum AM, Turner R, Whitcomb DC, Papachristou GI, Yadav D. The role of apheresis in hypertriglyceridemia-induced acute pancreatitis: a systematic review. Pancreatology 2015;15:313-20.
  • [25] Uyar S, Harmandar F, Kok M, Tas Z, Dolu S, Tokuc A, et al. Management of hypertriglyceridemia induced acute pancreatitis and therapeutic plasmapheresis : report of nine cases and review of literature. Acta Gastroenterol Belg 2017;80:71-4.
  • [26] Disel NR, Akpinar AA, Sebe A, Karakoc E, Surer S, Turhan FT, et al. Therapeutic plasma exchange in poisoning: 8 years’ experience of a university hospital. Am J Emerg Med 2015;33:1391-5.
Birincil Dil en
Konular Sağlık Bilimleri
Dergi Bölümü Original Article
Yazarlar

Orcid: 0000-0002-6488-1535
Yazar: Yasemin Tekdöş Şeker
Kurum: Department of Anesthesia and Reanimation, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul
Ülke: Turkey


Orcid: 0000-0003-3933-3534
Yazar: Gülsüm Oya Hergünsel
Kurum: Department of Anesthesia and Reanimation, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul
Ülke: Turkey


Yazar: Deniz Özel Bilgi
Kurum: Department of Anesthesia and Reanimation, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul
Ülke: Turkey


Bibtex @araştırma makalesi { eurj356552, journal = {The European Research Journal}, issn = {}, eissn = {2149-3189}, address = {Sağlık Araştırmaları ve Stratejileri Derneği}, year = {2018}, volume = {4}, pages = {343 - 348}, doi = {10.18621/eurj.356552}, title = {Therapeutic plasmapheresis: an eleven-year clinical experience}, key = {cite}, author = {Tekdöş Şeker, Yasemin and Hergünsel, Gülsüm Oya and Özel Bilgi, Deniz} }
APA Tekdöş Şeker, Y , Hergünsel, G , Özel Bilgi, D . (2018). Therapeutic plasmapheresis: an eleven-year clinical experience. The European Research Journal, 4 (4), 343-348. DOI: 10.18621/eurj.356552
MLA Tekdöş Şeker, Y , Hergünsel, G , Özel Bilgi, D . "Therapeutic plasmapheresis: an eleven-year clinical experience". The European Research Journal 4 (2018): 343-348 <http://dergipark.gov.tr/eurj/issue/32988/356552>
Chicago Tekdöş Şeker, Y , Hergünsel, G , Özel Bilgi, D . "Therapeutic plasmapheresis: an eleven-year clinical experience". The European Research Journal 4 (2018): 343-348
RIS TY - JOUR T1 - Therapeutic plasmapheresis: an eleven-year clinical experience AU - Yasemin Tekdöş Şeker , Gülsüm Oya Hergünsel , Deniz Özel Bilgi Y1 - 2018 PY - 2018 N1 - doi: 10.18621/eurj.356552 DO - 10.18621/eurj.356552 T2 - The European Research Journal JF - Journal JO - JOR SP - 343 EP - 348 VL - 4 IS - 4 SN - -2149-3189 M3 - doi: 10.18621/eurj.356552 UR - http://dx.doi.org/10.18621/eurj.356552 Y2 - 2018 ER -
EndNote %0 The European Research Journal Therapeutic plasmapheresis: an eleven-year clinical experience %A Yasemin Tekdöş Şeker , Gülsüm Oya Hergünsel , Deniz Özel Bilgi %T Therapeutic plasmapheresis: an eleven-year clinical experience %D 2018 %J The European Research Journal %P -2149-3189 %V 4 %N 4 %R doi: 10.18621/eurj.356552 %U 10.18621/eurj.356552
ISNAD Tekdöş Şeker, Yasemin , Hergünsel, Gülsüm Oya , Özel Bilgi, Deniz . "Therapeutic plasmapheresis: an eleven-year clinical experience". The European Research Journal 4 / 4 (Ekim 2018): 343-348. http://dx.doi.org/10.18621/eurj.356552