Safety and efficacy of therapeutic membrane plasmapheresis in the treatment of Guillain–Barré syndrome: A study from a tertiary care hospital from India

Abstract

Reports on therapeutic plasma exchange (TPE) with the standard hemodialysis equipment are scarce, particularly from developing countries. A retrospective analysis of safety and efficacy of membrane-based TPE with a standard hemodialysis equipment for the treatment of severe Guillain-Barré syndrome (GBS) was conducted. A total of 120 TPE sessions were performed in 31 GBS patients over a period of 5½ years. Each patient underwent a mean of 3.8 ± 1.5 TPE sessions. One (3.2%) patient died. Thirty (96.8%) patients survived and recovered. At 2 weeks, there was a significant improvement in the grade of power in both the upper and lower extremities (P = 0.001) and a significant decrease in the GBS disability grade (P = 0.001). Twenty four (77.4%) patients were able to walk unaided. Complications observed were: hypotension in 12 (10%), accelerated hypertension in 3 (2.5%), chills and rigors in 5 (4.2%), bleeding in 5 (4.2%), and filter clotting in 6 (5%) sessions. One patient experienced an anaphylactoid reaction and 1 patient survived a cardiorespiratory arrest. Two patients developed aspiration pneumonia and 1 patient developed catheter site infection. Membrane-based TPE can be conveniently delivered with the standard hemodialysis equipment. It is a safe, effective, and comparatively less expensive treatment option for GBS.