National Institute of Diabetes and Digestive and Kidney Diseases National Institute of Health Bethesda, MD; Department of Medicine, University of Maryland School of Medicine Baltimore, MD.
Department of Critical Care Medicine, National Institute of Health Bethesda, MD.
J Cardiothorac Vasc Anesth. 2020 Dec;34(12):3429-3443. doi: 10.1053/j.jvca.2020.01.054. Epub 2020 Feb 8.
Therapeutic plasma exchange (TPE) has a number of applications in cardiac surgical patients and has been used increasingly in high-risk heart and lung transplant patients. In this narrative review, the authors describe TPE principles, complications, and specific indications for TPE, including thrombotic thrombocytopenic purpura, heparin-induced thrombocytopenia, induction of immunotolerance in heart and lung transplant patients, and treatment of antibody-mediated rejection in heart and lung transplant patients. The review is based on published literature and the authors' institutional experience with perioperative TPE in cardiac surgical patients.
治疗性血浆置换（TPE）在心脏外科患者中有多种应用，并已在高危心肺移植患者中越来越多地使用。在这篇叙述性综述中，作者描述了 TPE 的原理、并发症和 TPE 的具体适应证，包括血栓性血小板减少性紫癜、肝素诱导的血小板减少症、诱导心肺移植患者免疫耐受以及治疗心肺移植患者的抗体介导的排斥反应。该综述基于已发表的文献和作者所在机构在心脏外科患者围手术期 TPE 方面的经验。
