[Therapeutic plasma exchange. Experience in 102 patients]

Rev Med Chil. 2022 Feb;150(2):147-153. doi: 10.4067/S0034-98872022000200147.
[Article in Spanish]

Abstract

Background: Therapeutic Plasma Exchange (TPE) is a procedure in which plasma and harmful macromolecules are separated from the rest of the blood components by centrifugation or filtration through membranes and are replaced with solutions with albumin and/or plasma.

Aim: To communicate our experience using TPE by filtration.

Material and methods: Review of records of 655 TPE sessions performed in 102 patients aged 50 ± 18 years (64% women). The requirement of renal replacement therapy (RRT) and seven days and one year mortality were recorded.

Results: Forty five percent of patients had hypertension or diabetes. The main indications for TPE were pulmonary-renal syndrome (PRS) (62%) and antibody mediated graft rejection (29%), followed by neurological diseases (36%). Fifteen percent of patients required RRT for one year. Mortality at seven days and one year was 20 and 30%, respectively. Out of the total of deaths associated with kidney diseases, 88% corresponded to PRS and ANCA vasculitis. The main complications were thrombocytopenia in 41%, hypocalcemia in 18%, and hypotension in 16%.

Conclusions: In our experience, TPE by filtration is a safe technique, with mild and preventable complications. Despite this, the reported mortality is high, which reflects the severity of the diseases that motivated the indication for TPE.

MeSH terms

  • Albumins
  • Antibodies, Antineutrophil Cytoplasmic*
  • Female
  • Glomerulonephritis
  • Hemorrhage
  • Humans
  • Lung Diseases
  • Male
  • Plasma Exchange* / adverse effects
  • Plasma Exchange* / methods
  • Retrospective Studies

Substances

  • Albumins
  • Antibodies, Antineutrophil Cytoplasmic

Supplementary concepts

  • Rapidly progressive glomerulonephritis with pulmonary hemorrhage