Single Donor Plasma in Therapeutic Plasma Exchange for Myasthenia Gravis

Abstract

Thirty-seven myasthenic patients were treated with therapeutic plasma exchange (TPE) on different performance schedules using either random or single donor plasma. The two schedules had the same effects in terms of efficacy but single donor replacement gave significantly less side effects in the short and long term. A two exchange procedure on alternate days associated with immunosuppression seems to be an optimal schedule for the treatment of myasthenic patients. A single donor two-exchange on alternate days procedure appears to be safe, useful and can be repeated in patients who need frequent TPE.

Comparative efficacy of low dose, daily versus alternate day plasma exchange in severe myasthenia gravis

“…The present study used the same dose and we noted good response in 81.8% patients, which is similar to other reports [5,19,20]. Removal of 40-50 ml/kg during each session is supported by studies of PE on patients with acute inflammatory polyneuropathy, [21] but studies using removal of 0.5, 0.8, 1 and 1.5 times the plasma volume per session, in MG patients have not found significant difference between various regimens and there are no randomized trials to support any particular regimen [5,6,22].…”

Double filtration plasmapheresis in myasthenia gravis - analysis of clinical efficacy and prognostic parameters

“…Plasmapheresis is highly effective in reducing the serum level of AchRAb titer and results in shortterm clinical improvement (1,2). The reported response rate of PE in the treatment of MG is highly variable, ranging from 58 to 100% (4)(5)(6)(7)(8)(9)(10)(11)(12)(13). DFP provides more selective removal of pathogenic factors via the mechanisms of filtration as compared to the unselective elimination of total plasma in PE (17).…”

Optimal volume of processed plasma and total number of selective plasmapheresis sessions in the treatment of patients with severe generalized Myasthenia Gravis

“…The selection of the technical parameters of plasmapheresis in the treatment of patients with MG varies widely due to the lack of sufficient data from controlled studies to standardize the plasmapheresis procedure [ [4][5][6][7]. The choice of plasmapheresis protocol is often empirical.…”

“…There have been few controlled studies, which compared the efficacy among different plasmapheresis protocols [4,6,7]. In this study, we evaluated and compared the efficiency of AchRAb removal in the DF and IA methods by accessing the functional capacity of plasmapheresis columns.…”