Document Detail

Complications of therapeutic plasma exchange: a prospective study of 1,727 procedures.
MedLine Citation:
PMID:  17722046     Owner:  NLM     Status:  MEDLINE    
The type and number of complications was prospectively examined in 1,727 successive TPE treatments in 174 patients over 66 months at a single center. Most treatments were prescribed for thrombotic thrombocytopenic purpura (TTP; 42%), recurrent focal segmental glomerulosclerosis (FSGS; 22%), or myasthenia gravis (MG; 13%). About 57% of treatments used albumin-saline as the replacement solution and 43% used fresh-frozen plasma (FFP), almost all for TTP. There were 889 complications; 614 treatments (36% of the total) involved a complication. Most complications were minor; there were no deaths. Three treatments (0.2%) were discontinued due to a complication, and 2 (0.1%) required transfer to a higher acuity hospital bed. The most common complications were fever (7.7% of treatments), urticaria (7.4%), and hypocalcemic symptoms (7.3%). 42% of treatments with FFP involved a complication, compared to 30% of treatments using albumin-saline (P < 0.0001). The most common complications with FFP were urticaria (17%) and pruritus (13%); these occurred more commonly than in patients receiving albumin-saline. The most common complications with albumin-saline replacement were hypocalcemic symptoms (8.2%) and mild hypotension (8.1%). Mild and severe hypotension was significantly (P < 0.0001) more common with albumin-saline replacement. TPE is associated with a number of minor complications. Complications occur more commonly with FFP replacement compared to albumin-saline replacement. Pruritus and urticaria occur more commonly with FFP, and hypotension occurs more commonly with albumin-saline.
Douglas Shemin; Doris Briggs; Melanie Greenan
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of clinical apheresis     Volume:  22     ISSN:  0733-2459     ISO Abbreviation:  J Clin Apher     Publication Date:  2007  
Date Detail:
Created Date:  2007-10-18     Completed Date:  2007-12-13     Revised Date:  2009-02-26    
Medline Journal Info:
Nlm Unique ID:  8216305     Medline TA:  J Clin Apher     Country:  United States    
Other Details:
Languages:  eng     Pagination:  270-6     Citation Subset:  IM    
Copyright Information:
Copyright 2007 Wiley-Liss, Inc.
Division of Renal Diseases, Rhode Island Hospital, Department of Medicine, Brown University School of Medicine, Providence, Rhode Island 02903, USA.
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MeSH Terms
Aged, 80 and over
Albumins / therapeutic use*
Glomerulosclerosis, Focal Segmental / therapy
Middle Aged
Myasthenia Gravis / therapy
Plasma Exchange / adverse effects*
Prospective Studies
Purpura, Thrombotic Thrombocytopenic / therapy
Treatment Outcome
Reg. No./Substance:

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