Hemolysis and acute renal failure due to the administration of albumin diluted in sterile water

Hemolytic events during therapeutic plasma exchange: Root cause analysis

“…[2] Interestingly, hemolytic reaction during TPE has been noted in the United States between 1994 and 1998. [34] However, these reports were due to 25% albumin diluted to 5% albumin with sterile water. As per the guidelines for quality control testing of human albumin solution, 96% of the protein content should be albumin and normal sodium levels are 130–160 mmol/L.…”

Hemolysis during therapeutic plasma exchange: A rare phenomena

“…2 However, it is infrequent in procedures performed using the centrifugation method and the only reported cause is the use of 25% albumin diluted to 5% albumin using sterile water as a replacement fluid. [1][2][3][4] Currently, therapeutic apheresis procedures are being performed using 5% albumin or 20% albumin (reconstituted in normal saline) is being used as replacement fluid. Here, we report an interesting case where hemolysis was seen during therapeutic plasma exchange (TPE) which was performed using cell separator machine.…”