Therapeutic Plasma Exchange Indications, Complications and Responses in Internal Medicine Patients: A Single Center, Retrospective Analysis

Therapeutic plasma exchange (TPE) is a process that allows high molecular weight substances to be removed from plasma. Therapeutic plasma exchange is widely used in many diseases in the practice of internal medicine. Current guidelines on this process have been published in recent years due to increased awareness and accessibility. The most common and most comprehensive of these is the American Apheresis Society (ASFA) guideline. In this study, we retrospectively determined the demographic data, underlying diseases, biochemical parameters, volume and type of replacement fluid, complications developed during and after the procedure, additional treatments, need for dialysis, and the number of sessions for patients who underwent therapeutic plasma exchange for any reason in the internal medicine clinic aimed to reveal aspects that can be improved in clinical practice. In the study, 117 patients between 2007 and 2016 were evaluated retrospectively. Of all cases, 63 (53.8%) were female. At the time of diagnosis, the mean age of the patients was 52.15 ± 16.8 (20-88) years. The most common indications for TPE were thrombotic thrombocytopenic purpura (TTP) and ANCA-associated vasculitis. Fresh frozen plasma and albumin were the most commonly used replacement fluids. Catheter related complication rate was 5.1%. The rate of complication related to TPE during TPE was 19.6%. No fatal reactions to TPE treatment were observed. There was a significant relationship between alkaline phosphatase (ALP) and mortality when the relationship between the laboratory data and the mortality rate of the patients with TTP was considered (p = 0.002). There was a significant correlation between chlorine and hematocrit and mortality in ANCA-associated vasculitis patients (p = 0.029 and p= 0.037, respectively). For the purpose of estimating mortality, further work is needed to confirm the validity of these laboratory data. As a result; TPE is a useful, easy and effective life saving treatment with few side effects