Département de Néphrologie et Transplantation d'Organes, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Institut National de la Santé et de la Recherche Médicale, UMR1048, Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse, France; Université Paul Sabatier - Toulouse 3, Toulouse, France.
Département de Néphrologie et Transplantation d'Organes, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
Transfus Apher Sci. 2020 Dec;59(6):102990. doi: 10.1016/j.transci.2020.102990. Epub 2020 Nov 19.
Thrombotic microangiopathy (TMA) brings together many diseases that have a commonality in the apparition of mechanical hemolysis with consuming thrombopenia. In all cases, these diseases can be life threatening, thereby justifying the implementation of treatment as an emergency. First-line treatment represents plasma exchange. This treatment has proven efficiency in improving the vital patient's and functional prognosis. However, the administration methods of plasma exchange can be redefined in light of the understanding of the pathophysiology of TMA. The aim of this review is to try to define, from pathophysiology, the place of plasma exchanges in the modern therapeutic arsenal of TMA.
血栓性微血管病（TMA）将具有机械性溶血性贫血和消耗性血小板减少症共同表现的多种疾病汇集在一起。在所有情况下，这些疾病都可能危及生命，因此有理由将治疗作为紧急措施。一线治疗代表血浆置换。这种治疗方法已被证明可有效改善患者的生命和功能预后。然而，鉴于对 TMA 病理生理学的理解，血浆置换的管理方法可以重新定义。本综述的目的是尝试从病理生理学的角度来确定血浆置换在 TMA 现代治疗武器库中的地位。
