Why nephrologists should perform therapeutic plasma exchange

Kaplan, André A.

doi:10.1002/dat.20293

Cited by 11 publications

(16 citation statements)

References 24 publications

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“…In Germany and Japan, an estimated 90% of TPE treatments are membrane‐based . Since nephrologists are well trained in the management of extracorporeal blood purification systems and the advancement in technology has allowed performing mTPE using dialysis equipment and dialysis staff, mTPE is gaining popularity amongst nephrologists in the United States …”

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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“…Nephrologists undergo extensive training in the management of blood purification treatments, including vascular access, anticoagulation, volume management, and prescription for solute clearance. 11 The diseases for which the use of TA is discussed and the guidelines on the use of TA provided by the Apheresis Applications Committee (AAC) of the American Society for Apheresis (ASFA) have been discussed in previous studies. 12,13 TA methods, such as TPE, and semi-or selective plasma exchange methods, such as selective adsorbers, IA, were discussed by Bambauer et al 14 Adsorptive cytapheresis mentioned in previous studies is a therapeutic procedure in which blood from the patient is passed through a medical device that contains a column or filter that selectively adsorbs activated monocytes and granulocytes and the remaining part of the blood is returned to the patient.…”

Section: Methodsmentioning

confidence: 99%

Therapeutic Apheresis in Dermatological Diseases

Bambauer¹,

Burgard²,

Schiel³

2015

Clinical Medicine Insights: Therapeutics

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Since the mid-1970s, membrane modules became available and plasma separation techniques have gained importance. Therapeutic apheresis (TA) has been successfully introduced in a variety of autoantibody-mediated diseases. In dermatology, TA is increasingly applied as a support treatment for severe and/or refractory autoimmune bullous diseases. All autoimmune disease are characterized by autoantibodies mediated against structural proteins of the skin and/or mucous membranes. Autoimmune blistering diseases have a high morbidity and mortality. These diseases include pemphigus vulgaris and bullous pemphigoid among others. Drug-induced pemphigus and other forms, such as dermatitis herpetiformis, herpes gestationis, scleroderma, pyoderma gangrenosum, epidermal necrolysis, Behcet disease, psoriasis vulgaris, Henoch-Schönlein purpura, and porphyria cutanea tarda, are also mentioned. Pathogenetical aspects of autoantibodies in these diseases are clearly demonstrated. TA has been shown to effectively remove the autoantibodies from blood and lead to rapid clinical improvement.

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“…Since the introduction of hollow fiber modules in TPE, this therapy method is mostly used in nephrology, as many of these membranes can be used with currently available dialysis equipment. Nephrologists have an extensive training in the management of blood purification treatments including vascular access, anticoagulation, volume management and prescription for solute clearance [1]. The renal indications for TPE expand the clinical practice of nephrologists.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic apheresis in nephrology

Bambauer¹,

Bambauer²,

Latza³

et al. 2014

Clin Nephrol Urol Sci

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Therapeutic plasma exchange (TPE) with hollow fiber modules is used in different severe diseases since more than 35 years. Based on many years of experience with the extracorporeal circulation in end-stage renal disease, the authors try to give an overview of therapeutic apheresis (TA) in renal diseases. The updated information on immunology and molecular biology of different renal diseases are discussed in relation to the rationale for apheresis therapy and its place in combination with other modern treatments. The different renal diseases can be treated by various apheresis methods such as TPE with substitution solution, or with online plasma or blood purification using adsorption columns which contain biological or non biological agents. The following diseases are discussed: rapidly progressive glomerulonephritis (RPGN) including anti-glomerular basement membrane antibody glomerulonephritis (anit-GBM RPGN), RPGN with or without glomerular deposition (ANCA-ab), pauci-immune RPGN, immune complex nephritis (ICN), and various glomerulonephritis with nephrotic syndrome (NS), hemolytic-uremic syndrome (HUS), myoglobulinemic renal failure, acute kidney injury (AKI), and kidney transplant rejection. For the renal diseases which can be treated with TA the guidelines of the Apheresis Applications Committee (AAC) of the American Society for Apheresis (ASFA) are cited.

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Why nephrologists should perform therapeutic plasma exchange

Cited by 11 publications

References 24 publications

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

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

Therapeutic Apheresis in Dermatological Diseases

Therapeutic apheresis in nephrology

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