Information about therapeutic plasma exchange (TPE) in developing countries is lacking. We report our experience with TPE performed for different indications during a 7-year period. We reviewed all TPE procedures performed in our institution during a 7-year period. Patients were divided in four groups according to the following indications: thrombotic microangiopathies (TM), myasthenia gravis (MG), polyneuropathies (PNP), and miscellaneous indications (MI). Clinical outcome (CO) and complications were evaluated. Eighty-seven procedures were carried out in 81 patients, for a total of 376 TPE sessions. Eighty-two procedures were analyzed for CO. In the group of TM we had 65% overall response rate (ORR): 35% complete response (CR) and 30% partial response (PR). Six (28.6%) patients died in this group. In the MG group we had 90% ORR: 69% CR and 21% PR. In the PNP group we had 78% ORR: 56% CR and 22% PR. In the MI group we had 92% ORR: 59% CR and 33% PR. We observed 47 adverse reactions in 40 (46%) procedures performed in 38 (47%) patients. This represented 12.5% of sessions. We had seven major complications leading to TPE discontinuation; this represented 8% of the procedures and 1.8% of sessions. One patient (0.2%) died during TPE. Our overall results are acceptable. In the TM group our results are somewhat lower than in other published reports, but in MG and PNP our results are similar to other published reports. Our complication rate is similar to that reported by others. Careful selection of patients and protocols is crucial to achieve maximum bene®t from TPE programs in countries where plasmapheresis facilities are not widely available. Am.

The PROCLEIX West Nile virus (WNV) assay is based on transcription-mediated amplification and is the most sensitive nucleic acid test commercially available today for blood screening. Since 2003, in the USA, the assay has been used for year-round screening of blood donations in minipools of 16 and in an individual-donation testing format, when appropriate triggering guidelines for such switch become effective. The test can be run on the semiautomated PROCLEIX modular platform or the fully-automated PROCLEIX TIGRIS System. This assay and the corresponding platforms have been developed and are manufactured by San Diego-based Gen-Probe, Inc., while they are marketed and distributed by Chiron, a Novartis business. This review covers some of the epidemiological and virological aspects of WNV, as well as clinical questions and technological assessment of the transcription-mediated amplification and alternative technologies used in WNV blood screening.

TPE with a mixture of 3% HES and 5% human albumin is as effective and safe as 5% human albumin alone for patients with these diseases.

Hyperviscosity syndrome is a disorder first described in patients with Waldenström's macroglobulinemia and is not commonly seen in rheumatic diseases. Its association with Sjögren's syndrome is very rare and it has been reported in very few patients. We report the case of a patient with primary Sjögren's syndrome presenting as hyperviscosity syndrome who was successfully treated with therapeutic plasma exchange.

WNV is present in the Mexican blood supply and measures should be taken to reduce the risk of transfusion transmission.