Therapeutic plasma exchange without anticoagulation: Single-center experience

Ther Apher Dial. 2024 Nov 5. doi: 10.1111/1744-9987.14227. Online ahead of print.

Abstract

Background: Membrane therapeutic plasma exchange (mTPE) is indicated for treating autoimmune, neurological, hematological, and renal diseases. Few studies have assessed the effectiveness and safety of this technique, especially when no anticoagulants are added. This study evaluated the outcomes of mTPE without anticoagulation at a single center.

Methods: Based on registry data, this retrospective cohort study included adult patients treated with mTPE without anticoagulants for different indications.

Results: From October 2021 to October 2022, 46 patients received 385 mTPE treatments. The primary diagnosis leading to the intervention was humoral rejection of the kidney transplant (59.2%). Most procedures (62.1%) were performed in the inpatient department. The complication rate was 1.3%, with 2.1% of patients experiencing device coagulation. Only five patients experienced mild adverse events. There were no cases of mortality.

Conclusions: When indicated, mTPE without anticoagulation is a safe hospital technique. Protocols are needed to guide the use and monitoring of this therapy.

Keywords: hospitalization; plasma exchange; plasma filtration; plasmapheresis; therapeutic plasma exchange.

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