Therapeutic plasma exchange in patients with thrombotic thrombocytopenic purpura-hemolytic uremic syndrome: the 10-year experience of a single center

Abstract

Background: Therapeutic plasma exchange (TPE) has been used for the treatment of patients with thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS). We report the 10-year treatment results along with the risk factors analyses.

Methods: Retrospective analyses were performed on patients who were treated with TPE for TTP-HUS.

Results: Fifty-two patients were included. Secondary causes were identified in 38 patients (73·1%). The others were classified as idiopathic. After a median five sessions of TPE, 26 patients (50·0%) achieved remission. Remission rate in patients with idiopathic and secondary TTP-HUS was 71·4 and 42·1%, respectively. Overall 30-day mortality rate was 34·6% and median overall survival was 5·2 months. Patients with hematopoietic stem cell transplantation-associated TTP-HUS did not respond and had poor overall survival. Males had a lower remission rate than females (P = 0·009).

Conclusions: TPE was an effective treatment in patients with idiopathic TTP-HUS. Treatment results were various according to etiology and gender.