Sengul Samanci Nilay, Ayer Mesut, Gursu Meltem, Ar Muhlis Cem, Yel Kubra, Ergen Abdulkadir, Dogan Elif Ece, Karadag Serhat, Cebeci Egemen, Toptas Mehmet, Kazancioglu Rumeyza, Ozturk Savas
Department of Internal Medicine, Haseki Training and Research Hospital, Istanbul, Turkey.
Department of Hematology, Haseki Training and Research Hospital, Istanbul, Turkey.
Transfus Apher Sci. 2014 Dec;51(3):83-9. doi: 10.1016/j.transci.2014.10.006. Epub 2014 Oct 8.
Therapeutic Plasma Exchange (TPE) is a therapeutic procedure that is used to remove high molecular weight substances from plasma. We analyzed data of patients who received TPE during the last 7 years, and focused on the efficiency of TPE in various disease groups.
We studied 110 patients treated with TPE by membrane plasma separation technique from 2007 to 2013. We examined the demographic data, underlying disease, biochemical parameters, volume and type of replacement fluid, complications, concomitant treatment, the need for hemodialysis and number of TPE sessions.
One hundred ten patients, 58 male, 52 female were included. The mean age was 47.3 ± 17.6 years. A total of 734 TPE sessions were performed and the mean number of TPE sessions per patient was 6.6 ± 4.3. The underlying disease was renal transplantation in 26 patients, ANCA-associated vasculitis in 18, rapidly progressive glomerulonephritis in 17, hemolytic uremic syndrome in 11, thrombotic thrombocytopenic purpura in 9, autoimmunic hemolytic anemia in 6, focal segmental glomerulosclerosis in 6 and other diseases. Partial and complete remission was obtained in 65 (59.1%) and 24 patients (21.8%) respectively, while 14 (12.7%) patients had no response and 7 (6.4%) patients died. Complications were muscle cramps (6.4%), allergic reactions (4.5%), severe hypotension (3.6%), fever (1.8%), unconsciousness (0.9%), leukopenia (0.9%) and catheter related hematoma (0.9%).
According to our 7 years of experience in TPE, we can say that therapeutic plasma exchange by membrane separation technique is a useful, easy, available and effective life-saving therapeutic treatment.
治疗性血浆置换（TPE）是一种用于从血浆中去除高分子量物质的治疗方法。我们分析了过去7年接受TPE治疗的患者数据，并重点关注TPE在不同疾病组中的疗效。
我们研究了2007年至2013年采用膜血浆分离技术接受TPE治疗的110例患者。我们检查了人口统计学数据、基础疾病、生化参数、置换液的量和类型、并发症、伴随治疗、血液透析需求以及TPE治疗次数。
纳入110例患者，其中男性58例，女性52例。平均年龄为47.3±17.6岁。共进行了734次TPE治疗，每位患者的TPE平均治疗次数为6.6±4.3次。基础疾病包括26例肾移植患者、18例抗中性粒细胞胞浆抗体相关性血管炎患者、17例急进性肾小球肾炎患者、11例溶血尿毒综合征患者、9例血栓性血小板减少性紫癜患者、6例自身免疫性溶血性贫血患者、6例局灶节段性肾小球硬化患者以及其他疾病患者。分别有65例（59.1%）和24例（21.8%）患者获得部分缓解和完全缓解，而14例（12.7%）患者无反应，7例（6.4%）患者死亡。并发症包括肌肉痉挛（6.4%）、过敏反应（4.5%）、严重低血压（3.6%）、发热（1.8%）、意识丧失（0.9%）、白细胞减少（0.9%）和导管相关血肿（0.9%）。
根据我们7年的TPE治疗经验，可以说膜分离技术进行的治疗性血浆置换是一种有用、简便、可行且有效的挽救生命的治疗方法。
