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Therapeutic plasma exchange in a single center: Ibni Sina experience.
Transfus Apher Sci. 2004 Jun; 30(3):181-4.TA

Abstract

BACKGROUND

The number of therapeutic procedures is increasing steadily year by year with growing collaboration of departments other than Hematology. In the aim to demonstrate our single center activity we analyzed our data since four years.

METHODS

Between years 1998 and 2001, 658 therapeutic plasma exchange (TPE) procedures were performed on 158 patients. Median age and male/female ratio were 37 (range, 15-87) and 80/78, respectively. Main indications were myastenia gravis (n=55, 34%), TTP (n=13, 8.5%), post ABO mismatched allogeneic hematopoietic cell transplantation aregeneratoric anemia (n=6, 7.5%), progressive systemic sclerosis (n=10, 6.5%), multiple myeloma (n=10, 6.5%), Gullian Barre Syndrome (n=9, 5.9%), multiple sclerosis (n=7, 4.6%), Waldenström Macroglobulinemia (n=5, 3.4%), polymyositis (n=4, 2.7%), sepsis and disseminated intravascular coagulation (n=4, 2.7%). Departments who referred the majority of the patients for TPE were neurology (n=199), hematology (n=153), immunology (n=78), intensive care unit (n=78) and thorax surgery (n=51).

RESULTS

The median TPE procedure per patient was 4 (range, 1-50). All the procedures were performed on continuous flow cell separators and median plasma volume processed per cycle was 2471 ml (range 436-5000). The replacement fluids used were 3% hydroxyethylstarch (HES) (24%), 5% albumin (35%), fresh frozen plasma (25%), and HES and albumin (16%). HES was tolerated well even as a sole replacement fluid with acceptable minor side effects. In three patients with progressing hypoalbuminemia HES was replaced or combined with 5% albumin. Close monitoring of serum albumin and fibrinogen levels after repeated procedures is mandatory.

CONCLUSION

In our four years of TPE experience we have increased our collaboration with other departments. 3% HES+/-5% Albumin is a feasible, well tolerated and cost effective replacement fluid combination especially for short-term plasma exchange therapy.

Authors+Show Affiliations

Ankara University Faculty of Medicine, Ibni Sina Hospital, Department of Hematology, Hemapheresis Unit & Blood Bank, Sihhiye 06100 Ankara, Turkey. arslan@medicine.ankara.edu.trNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15172620

Citation

Arslan, Onder, et al. "Therapeutic Plasma Exchange in a Single Center: Ibni Sina Experience." Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis, vol. 30, no. 3, 2004, pp. 181-4.
Arslan O, Arat M, Tek I, et al. Therapeutic plasma exchange in a single center: Ibni Sina experience. Transfus Apher Sci. 2004;30(3):181-4.
Arslan, O., Arat, M., Tek, I., Ayyildiz, E., & Ilhan, O. (2004). Therapeutic plasma exchange in a single center: Ibni Sina experience. Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis, 30(3), 181-4.
Arslan O, et al. Therapeutic Plasma Exchange in a Single Center: Ibni Sina Experience. Transfus Apher Sci. 2004;30(3):181-4. PubMed PMID: 15172620.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Therapeutic plasma exchange in a single center: Ibni Sina experience. AU - Arslan,Onder, AU - Arat,Mutlu, AU - Tek,Ibrahim, AU - Ayyildiz,Erol, AU - Ilhan,Osman, PY - 2004/01/01/received PY - 2004/02/01/accepted PY - 2004/6/3/pubmed PY - 2005/1/26/medline PY - 2004/6/3/entrez SP - 181 EP - 4 JF - Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis JO - Transfus Apher Sci VL - 30 IS - 3 N2 - BACKGROUND: The number of therapeutic procedures is increasing steadily year by year with growing collaboration of departments other than Hematology. In the aim to demonstrate our single center activity we analyzed our data since four years. METHODS: Between years 1998 and 2001, 658 therapeutic plasma exchange (TPE) procedures were performed on 158 patients. Median age and male/female ratio were 37 (range, 15-87) and 80/78, respectively. Main indications were myastenia gravis (n=55, 34%), TTP (n=13, 8.5%), post ABO mismatched allogeneic hematopoietic cell transplantation aregeneratoric anemia (n=6, 7.5%), progressive systemic sclerosis (n=10, 6.5%), multiple myeloma (n=10, 6.5%), Gullian Barre Syndrome (n=9, 5.9%), multiple sclerosis (n=7, 4.6%), Waldenström Macroglobulinemia (n=5, 3.4%), polymyositis (n=4, 2.7%), sepsis and disseminated intravascular coagulation (n=4, 2.7%). Departments who referred the majority of the patients for TPE were neurology (n=199), hematology (n=153), immunology (n=78), intensive care unit (n=78) and thorax surgery (n=51). RESULTS: The median TPE procedure per patient was 4 (range, 1-50). All the procedures were performed on continuous flow cell separators and median plasma volume processed per cycle was 2471 ml (range 436-5000). The replacement fluids used were 3% hydroxyethylstarch (HES) (24%), 5% albumin (35%), fresh frozen plasma (25%), and HES and albumin (16%). HES was tolerated well even as a sole replacement fluid with acceptable minor side effects. In three patients with progressing hypoalbuminemia HES was replaced or combined with 5% albumin. Close monitoring of serum albumin and fibrinogen levels after repeated procedures is mandatory. CONCLUSION: In our four years of TPE experience we have increased our collaboration with other departments. 3% HES+/-5% Albumin is a feasible, well tolerated and cost effective replacement fluid combination especially for short-term plasma exchange therapy. SN - 1473-0502 UR - https://www.unboundmedicine.com/medline/citation/15172620/Therapeutic_plasma_exchange_in_a_single_center:_Ibni_Sina_experience_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1473-0502(04)00050-3 DB - PRIME DP - Unbound Medicine ER -