Indications of Plasnapheresis and Selection of Different Substitution Solutions

Bambauer, Rolf; Jutzler, G. A.; Albrecht, Dirk; Keller, H.; Köhler, Michael

doi:10.3109/10731198909118265

Cited by 11 publications

(6 citation statements)

References 4 publications

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“…A significantly higher incidence of allergic reactions was recorded in patients requiring FFP (9.5%). Our results are comparable with those reported from other studies, where most reactions were limited to rigor or urticaria (3,5,22,23). Although most of these reactions were associated with the use of FFP, one should bear in mind that human serum albumin might contain trace amounts of globulins and other plasma constituents which might provoke anaphylactoid reaction.…”

Section: Discussionsupporting

confidence: 92%

Complications of Therapeutic Plasma Exchange: Experience With 4857 Treatments

et al. 2005

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Plasma exchange (PE) is a technique of extracorporeal blood purification which removes large molecular weight substances from plasma. The Department of Dialysis, Zagreb University Hospital Center's database, which includes data on 509 patients, or 4857 PE treatments, was retrospectively analyzed to test the safety of PE. A total of 231 adverse reactions were recorded (4.75% of treatments). The most common complications were paresthesias (2.7%), hematoma at the puncture site (2.4%), clotting (1.7%), mild to moderate allergic reactions (urticaria; 1.6%) and bleeding (0.06%). True anaphylactoid reactions were recorded in five procedures. The incidence of severe, potentially life-threatening adverse reactions was 0.12%. The prophylactic use of calcium and potassium was responsible for a low incidence of electrolyte disturbances. There was no lethal outcome associated with PE. When carried out by experienced staff, PE is a relatively safe procedure. The use of fresh frozen plasma is associated with a higher rate of adverse reactions.

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Section: Discussionsupporting

confidence: 92%

Complications of Therapeutic Plasma Exchange: Experience With 4857 Treatments

et al. 2005

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“…Regarding the replacement solution the clear trend to reduce the portion of FFP is apparent because in comparison with albumin it causes more side-effects. Similar developments have been described [ 3,9].…”

Section: Discussionsupporting

confidence: 71%

“…Small volumes exchanged or processed (e.g., 0.3-0.5 L) were reported in patients with side effects and discontinuation of the apheresis procedure. The total number of treatments per patient averaged 4.1 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) with a distribution as shown in Figure 1. The mean interval between treatments was 2.2 (1 to 9.8) days.…”

Section: Methods Of Treatmentmentioning

confidence: 99%

Three years with a national apheresis registry

Schmitt

Kundt

Klinkmann

1992

J of Clinical Apheresis

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The large number of unsolved problems in plasma exchange therapy makes an apheresis registry appear useful. The results of such an open prospective observational study from 1987 to 1989 in East Germany are presented in this paper. With 1,945 procedures in a total of 419 patients (on average 4.1 treatments per patient) about 80% of all treatments in the country were registered. Exchange volume averaged 2.7 (+/- 0.78) l or 43 (+/- 13.9) ml/kg body weight. Substitutes were albumin (51% of the cases), FFP (22%), and both (22%). Nephrological (25%) and neurological (23%) diagnoses prevailed among the treated diseases. Haematologic diseases (12%) were underrepresented and hepatic coma (20%) was overrepresented. Minor side effects occurred in 22% of all treatments and severe complications in 38 treatments (2%). Four fatalities probably resulted from plasmapheresis therapy. The registry permits an assessment of the treatment results and of several trends during the period of observation.

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“…Reactions to FFP are anaphylactoid in nature and are characterized by fever, rigors, urticaria, wheezing, and hypotension, and may eventually progress to laryngospasm (64,65). In a review of several large series, the reported incidence of this type of reaction was between 0.02% and 21% (12) (Table 1).…”

Section: Reactions To Protein‐containing Replacement Fluids (Ffp Plamentioning

confidence: 99%

Complications of Apheresis

Kaplan

2012

Seminars in Dialysis

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In general, therapeutic apheresis is a relatively safe procedure with the most commonly seen complications caused by citrate-induced hypocalcemia and urticarial reactions to the protein-containing replacement fluid. Depletion coagulopathy and immunoglobulin depletion must be anticipated when albumin is used as the replacement fluid and becomes more profound as the number of treatment increases. The most serious complications are seen when there is an anaphylactoid reaction to the multiple units of fresh frozen plasma required when used as the replacement fluid. The overall incidence of death is 0.05%, but many of these deaths were in patients with severe preexisting conditions in which the apheresis procedure, itself, may not have been the precipitating cause. As with all extracorporeal treatments requiring large bore vascular access, catheter-related trauma, clotting, infection, and bleeding may also occur.

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Indications of Plasnapheresis and Selection of Different Substitution Solutions

Cited by 11 publications

References 4 publications

Complications of Therapeutic Plasma Exchange: Experience With 4857 Treatments

Complications of Therapeutic Plasma Exchange: Experience With 4857 Treatments

Three years with a national apheresis registry

Complications of Apheresis

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