Outcomes of therapeutic plasma exchange: A 15-year tertiary center experience

Abstract

BACKGROUND: Therapeutic plasma exchange (TPE) is a treatment option used in many medical conditions. Response rates are variable as some disorders clearly benefit from TPE as first- or second-line therapy. This study aims to summarize our experience at King Abdulaziz University Hospital at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. MATERIALS AND METHODS: In a retrospective fashion, wdemographic data, underlying disease, apheresis-related parameters, and outcomes were collected. RESULTS: Between January 2005 and March 2020, 159 patients with 177 episodes underwent a total of 945 sessions of TPE. The majority of patients (96.8%) undergoing TPE in our center are of categories I to III according to 2019 American Society for Apheresis guidelines. Most patients had neurologic disorders, 74 (46.5%), where myasthenia gravis was the most common indication, 34 (21.4%) patients with response in 44/45 (97.8%) episodes, followed by thrombotic microangiopathies 31 (17.5%) patients with response in 17/34 (50%) episodes, Guillain–Barré syndrome 27 (16.9%) patients with recovery in 20/27 (74.1%) patients, and systemic lupus erythematous 25 (15.7%) patients with recovery in only 11/25 (44%) patients. Complications included hypotension in 29/945 (3.06%) sessions and citrate-induced symptoms in 6/945 (0.6%) sessions. CONCLUSION: Our center complies with the recommended standards of indications for initiating TPE. Neurologic conditions constitute the largest group of patients requiring TPE.

Keywords

• apheresis
• therapeutic plasma exchange
• thrombotic thrombocytopenic purpura