Therapeutic Plasma Exchange Performed Via 2 Apheresis Devices and its Impact on the Blood Profile of Hematological and Neurological Patients.

Abstract

An efficient apheresis device performs therapeutic plasma exchange (TPE) sessions in short times, while avoiding significant potential cell losses in the removed plasma. To evaluate TPE performed via Optia (hereinafter, Optia) and COBE Spectra (hereinafter, COBE) apheresis devices, a paired randomized comparison study was conducted. We evaluated the device performance and its impact on cell loss in the removed plasma, as well as blood counts of patients. In patients with thrombotic thrombocytopenic purpura (TTP), the median platelet content of the extracted plasma was 9.5 × 1000 per µL for Optia and 33.5 × 1000 per µL for COBE (P <.001). This finding resulted in a median drop in patient platelet count of 2.4% with with Optia, compared with 5.6% with the COBE instrument (P = .04). When using albumin as replacement fluid, the median platelet content of the waste bag was comparable with both machines. However, the drop in patient platelet count with COBE was significantly higher (17.5%) compared with Optia (8.3%; P = .04). Minimal changes were observed in the hemoglobin and white blood cells of patients, undergoing sessions on both machines. The Optia device seems to reduce significant platelet losses in patients undergoing TPE.