Retrospective evaluation of indications for therapeutic plasmapheresis procedures applied in our center

Abstract

Aims: Therapeutic plasma exchange (TPE) is a process in which pathological substances (autoantibodies, alloantibodies, immune complexes, lipoproteins, cryoglobulins, etc.) in the patient's plasma are removed from the body along with the patient's plasma and replaced with replacement fluid (allogeneic donor plasma, colloid, crystalloid). It is applied as a complementary treatment method in many diseases that can cause high morbidity and mortality, either in the primary treatment of the disease (main treatment) or as an adjunctive treatment in the main treatment of the disease. Today, TPE is increasingly used in various clinics (toxicology, endocrinology, etc.) for different diseases/causes, especially in hematological, neurological, and nephrological diseases. Methods: Adult patients who underwent therapeutic plasma exchange in our therapeutic apheresis center between May 2017 and May 2019 were included in the study, and the data were obtained by retrospectively reviewing patient records in the therapeutic apheresis center and our hospital's automation system. Results: In the two-year period, a total of 1957 TPE procedures were performed on 441 patients. It was determined that 255 of the patients undergoing TPE procedures (57.8%) had indications related to liver diseases (acute liver failure, acute exacerbation of chronic liver failure, and rejection after liver transplantation), while 186 (42.2%) had indications related to non-liver diseases. Among the 186 patients undergoing TPE for non-liver diseases, it was found that 69 (37.1%) were for hematological, 38 (20.4%) for neurological, 32 (17.2%) for renal, and 47 (25.3%) for other diseases. Conclusion: Due to the large number of liver transplants performed in our Liver Transplant Institute, the majority of TPE indications at our hospital are related to liver diseases. However, the evaluation of TPE indications excluding liver diseases revealed that the indications and frequencies of patients undergoing TPE were consistent with the overall results reported in studies from both our country and abroad.