Therapeutic apheresis: history, clinical application, and lingering uncertainties

McLeod, Bruce C.

doi:10.1111/j.1537-2995.2009.02505.x

Cited by 42 publications

(25 citation statements)

References 103 publications

(107 reference statements)

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“…Therapeutic plasma exchange (TPE) has been widely utilized in clinical medicine since the technical development of continuous flow centrifuges in the 1960 s for the treatment of a variety of immune‐mediated conditions . The common objective is improvement in disease outcome by removal of circulating pathogenic substances such as autoantibodies from the bloodstream .…”

Section: Introductionmentioning

confidence: 99%

Membrane‐based therapeutic plasma exchange (mTPE): Technical and clinical experience

Gashti

Andreoli

Patel

2017

J of Clinical Apheresis

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Therapeutic plasma exchange (TPE) has long been utilized to manage a variety of immune-mediated diseases. The basic principle relies on removal of circulating pathogenic substances from the bloodstream. Methods of plasma separation include centrifuge (cTPE) and membrane (mTPE). Although mTPE has existed for a few decades, recent advances in developing highly permeable filters that are compatible with currently existing dialysis machines has opened a new frontier. Published data in the area of technical and clinical experience with mTPE is lacking. We report our single center experience of 998 inpatient mTPE treatments performed in 237 patients at a large tertiary care academic center. The most common treatment indication was neurologic. We found a very low incidence of patient-reported complications. Filter clotting without the use of anticoagulation occurred in 7.7% of treatments. Laboratory parameters that significantly changed during the course of therapy included serum potassium, platelet count, and partial thromboplastin time. We found that mTPE can be safely and efficiently performed as an alternative to cTPE, and suggest an individualized approach when prescribing this therapy. K E Y W O R D Santicoagulation, complications, membrane, plasmapheresis, therapeutic plasma exchange

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Section: Introductionmentioning

confidence: 99%

Membrane‐based therapeutic plasma exchange (mTPE): Technical and clinical experience

Gashti

Andreoli

Patel

2017

J of Clinical Apheresis

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“…Therapeutic plasma exchange (TPE) has become increasingly popular over the last decades and has evolved to a safe and efficacious therapy in children with renal and other immune‐mediated diseases . TPE involves the removal of part of the patient's plasma, which is replaced with either albumin or donor plasma.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic plasma exchange in children: One center's experience

Cortina

Ojinaga

Giner

et al. 2017

J of Clinical Apheresis

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“…An anticoagulant, usually citrate, is added before centrifugation, which is then followed by return of the rest of the blood components with the appropriate replacement fluid (typically albumin or plasma) so that a continuous flow extracorporeal circuit is formed (7). The functional unit is the centrifuge itself, which spins at typical speeds of 2000-2500 rpm to separate the contents of the anticoagulated blood based on the density or specific gravity of various components of blood.…”

Section: Principles Of Centrifugal Separationmentioning

confidence: 99%

Principles of Separation

Williams

Balogun

2014

Clinical Journal of the American Society of Nephrology

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SummaryExtracorporeal "blood purification," mainly in the form of hemodialysis has been a major portion of the clinical activity of many nephrologists for the past 5 decades. A possibly older procedure, therapeutic plasma exchange, separates and then removes plasma as a method of removing pathogenic material from the patient. In contrast to hemodialysis, therapeutic plasma exchange preferentially removes biologic substances of high molecular weight such as autoantibodies or alloantibodies, antigen-antibody complexes, and Ig paraproteins. These molecular targets may be cleared through two alternative procedures: centrifugal separation and membrane separation. This review presents operational features of each procedure, with relevance to the nephrologist. Kinetics of removal of these plasma constituents are based on the principles of separation by the apheresis technique and by features specific to each molecular target, including their production and compartmentalization in the body. Molecular targets for common renal conditions requiring therapeutic plasma exchange are also discussed in detail.

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Therapeutic apheresis: history, clinical application, and lingering uncertainties

Cited by 42 publications

References 103 publications

Membrane‐based therapeutic plasma exchange (mTPE): Technical and clinical experience

Membrane‐based therapeutic plasma exchange (mTPE): Technical and clinical experience

Therapeutic plasma exchange in children: One center's experience

Principles of Separation

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