The complications of therapeutic plasma exchange.

We reviewed a series of 181 patients who were treated with therapeutic plasma exchange ( TPE ) a total of 1,389 times. Complications were associated with 22 (1.6%) of the procedures and involved 20 (11%) of the patients. Six of the complications were of a technical nature and did not affect the medical conditions of the patients. 8 patients developed the following serious medical problems: unexplained death during the post- TPE period, myocardial infarction, pulmonary embolus, loss of consciousness, myocardial ischemia, cerebral ischemia and chest pain. Although these problems were temporally associated with TPE none of them could be attributed to the TPE with certainty. The remaining eight medical complications were of a less serious nature.