Predictors of complications in therapeutic plasma exchange
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Predictors of complications in therapeutic plasma exchange. / Bramlage, Carsten P; Schröder, Katharina; Bramlage, Peter; Ahrens, Katharina; Zapf, Antonia; Müller, Gerhard Anton; Koziolek, Michael J.
In: J CLIN APHERESIS, Vol. 24, No. 6, 2009, p. 225-231.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Predictors of complications in therapeutic plasma exchange
AU - Bramlage, Carsten P
AU - Schröder, Katharina
AU - Bramlage, Peter
AU - Ahrens, Katharina
AU - Zapf, Antonia
AU - Müller, Gerhard Anton
AU - Koziolek, Michael J
PY - 2009
Y1 - 2009
N2 - Plasma exchange (PE) is used for blood purification to modulate proteins involved in pathological processes. As the number of patients receiving PE treatment and the heterogeneity of the underlying diseases is steadily increasing, we evaluated the most frequent complications and analyzed causes leading to adverse reactions. 883 PE procedures in 113 patients between the years 2000 to 2006 were retrospectively analyzed with respect to complications. Additionally, underlying diseases and settings of PE procedure were analyzed to identify high-risk patients and respective PE settings. A total of 226 adverse reactions were recorded (25.6% of all PE procedures). Most complications were mild (n = 121, 13.7%) or moderate (n = 98, 11.0%). In seven cases (n = 7, 0.7%), severe, life-threatening adverse events were induced by PE either due to severe allergic reactions (n = 4, 0.5%) or to sepsis (n = 3, 0.3%). Patients with neurologic diseases had a significantly higher risk to develop complications compared to those with internal diseases (P = 0.013). This was due to a higher rate of PE associated adverse events (in particular hypotension) and complications associated with vascular access. Among patients from internal medicine those with hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP) had the highest risk to develop complications. Patients with neurological diseases compared to those with medical conditions and patients with HUS/TTP compared to those with other diseases had a higher risk to develop complications. However, severe adverse events are rare. Thus, PE seems to be a safe and recommendable procedure.
AB - Plasma exchange (PE) is used for blood purification to modulate proteins involved in pathological processes. As the number of patients receiving PE treatment and the heterogeneity of the underlying diseases is steadily increasing, we evaluated the most frequent complications and analyzed causes leading to adverse reactions. 883 PE procedures in 113 patients between the years 2000 to 2006 were retrospectively analyzed with respect to complications. Additionally, underlying diseases and settings of PE procedure were analyzed to identify high-risk patients and respective PE settings. A total of 226 adverse reactions were recorded (25.6% of all PE procedures). Most complications were mild (n = 121, 13.7%) or moderate (n = 98, 11.0%). In seven cases (n = 7, 0.7%), severe, life-threatening adverse events were induced by PE either due to severe allergic reactions (n = 4, 0.5%) or to sepsis (n = 3, 0.3%). Patients with neurologic diseases had a significantly higher risk to develop complications compared to those with internal diseases (P = 0.013). This was due to a higher rate of PE associated adverse events (in particular hypotension) and complications associated with vascular access. Among patients from internal medicine those with hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP) had the highest risk to develop complications. Patients with neurological diseases compared to those with medical conditions and patients with HUS/TTP compared to those with other diseases had a higher risk to develop complications. However, severe adverse events are rare. Thus, PE seems to be a safe and recommendable procedure.
KW - Adult
KW - Aged
KW - Female
KW - Hemolytic-Uremic Syndrome
KW - Humans
KW - Hypersensitivity
KW - Hypotension
KW - Male
KW - Middle Aged
KW - Plasma Exchange
KW - Purpura, Thrombotic Thrombocytopenic
KW - Retrospective Studies
KW - Risk Factors
KW - Journal Article
U2 - 10.1002/jca.20217
DO - 10.1002/jca.20217
M3 - SCORING: Journal article
C2 - 19890911
VL - 24
SP - 225
EP - 231
JO - J CLIN APHERESIS
JF - J CLIN APHERESIS
SN - 0733-2459
IS - 6
ER -