Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2022 Feb;37(1):54-64.
doi: 10.1002/jca.21950. Epub 2021 Nov 17.

Tolerance and complications of therapeutic plasma exchange by centrifugation: A single center experience

Valentin Coirier  1   2 , Mathieu Lesouhaitier  1   2 , Florian Reizine  1   2 , Benoît Painvin  1   2 , Quentin Quelven  1   2 , Adel Maamar  1   2 , Arnaud Gacouin  1   2 , Jean-Marc Tadié  1   2 , Yves Le Tulzo  1   2 , Christophe Camus  1   2
Affiliations
Free article
Observational Study

Tolerance and complications of therapeutic plasma exchange by centrifugation: A single center experience

Valentin Coirier et al. J Clin Apher. 2022 Feb.
Free article

Abstract

Introduction: Therapeutic plasma exchange (TPE) constitutes an important therapy for hematological, neurological, immunological, and nephrological diseases. Most studies have focused on efficacy, whereas tolerance and complications during sessions have been less well studied and not recently.

Material and methods: We conducted a single center retrospective study of all patients who underwent TPE between 2011 and 2018. TPE sessions using the centrifugation technique were performed by dedicated trained nurses. Specific side effects were identified through surveillance forms completed contemporaneously. The primary outcome was the rate of all-type adverse effects that occurred during the TPE sessions.

Results: In total, 1895 TPE sessions performed on 185 patients were analyzed. At least one adverse effect was reported for 805 sessions (42.5% [29.9%-70.1%]), corresponding to 171 patients (92.4% [87.6%-95.8%]). Hypotension occurred during 288 sessions (15.2%), was asymptomatic in 95.8% of cases, and more frequent with the use of 4% albumin than fresh frozen plasma (FFP) (19.8 vs 8.9%, P <.0001). Hypocalcemia occurred during 370 sessions (19.6%) and was more frequent with the use of FFP than with the use of albumin alone (FFP alone: 28.0%, albumin + FFP: 26%, albumin alone: 11.7%; P <.0001). Allergic reactions occurred during 56 sessions (3%), exclusively with FFP. Severe adverse effects were reported for 0.3% of sessions and 5.4% of patients.

Conclusions: TPE is a safe therapy when performed by a trained team. Adverse effects were frequent but mostly not serious. The replacement fluid was the main determinant of the occurrence of complications. (ClinicalTrials.gov ID: NCT03888417).

Keywords: albumin; allergic reaction; fresh frozen plasma; hypocalcemia; hypotension; therapeutic plasma exchange.

PubMed Disclaimer

References

REFERENCES

    1. Schwab PJ, Fahey JL. Treatment of Waldenström's Macroglobulinemia by plasmapheresis. N Engl J Med. 1960;263:574-579.
    1. van der Meché FG, Schmitz PI. A randomized trial comparing intravenous immune globulin and plasma exchange in Guillain-Barré Syndrome. Dutch Guillain-Barré Study Group. N Engl J Med. 1992;326:1123-1129.
    1. Jayne D, Gaskin G, Rasmussen N, et al. Randomized trial of plasma exchange or high-dosage methylprednisolone as adjunctive therapy for severe renal vasculitis. J Am Soc Nephrol. 2007;18:2180-2188.
    1. Rock GA, Shumak KH, Buskard NA, et al. Comparison of plasma exchange with plasma infusion in the treatment of thrombotic thrombocytopenic purpura. N Engl J Med. 1991;325:393-397.
    1. Larsen FS, Schmidt LE, Bernsmeier C, et al. High-volume plasma exchange in patients with acute liver failure: an open randomised controlled trial. J Hepatol. 2016;64:69-78.

Publication types

Associated data