Complications of plasma exchange in 71 consecutive patients treated for clinically suspected thrombotic thrombocytopenic purpura-hemolytic-uremic syndrome.

TitleComplications of plasma exchange in 71 consecutive patients treated for clinically suspected thrombotic thrombocytopenic purpura-hemolytic-uremic syndrome.
Publication TypeJournal Article
Year of Publication2000
AuthorsRizvi MA, Vesely SK, George JN, Chandler L, Duvall D, Smith JW, Gilcher RO
JournalTransfusion
Volume40
Issue8
Pagination896 - 901
Date Published2000
ISBN Number0041-1132
Other Numberswdn, 0417360
Keywords*Hemolytic-Uremic Syndrome/th [Therapy], *Plasma Exchange/ae [Adverse Effects], *Purpura, Thrombotic Thrombocytopenic/th [Therapy], Bacteremia/et [Etiology], Catheterization, Central Venous/ae [Adverse Effects], Fungemia/et [Etiology], Humans, Risk Factors
Abstract

BACKGROUND: With the increased frequency of diagnosis and improved survival of thrombotic thrombocytopenic purpura-hemolytic-uremic syndrome (TTP-HUS), the morbidity of plasma exchange (PE) treatment has become more important., STUDY DESIGN AND METHODS: Data were prospectively collected on 71 consecutive patients referred to the Oklahoma Blood Institute (OBI) for PE treatment for clinically suspected TTP-HUS from mid-1996 to mid-1999. Complications were defined as major or minor, and distinguished between those related to central venous catheter access or to the plasma., RESULTS: Twenty-one patients (30%) had 27 major complications, which caused two deaths. The major complications included 2 episodes of hemorrhage after subclavian line insertion (1 death), 1 pneumothorax requiring a chest tube, 12 systemic infections (1 death), 7 episodes of catheter thrombosis requiring removal of the central venous catheter, 2 episodes of venous thrombosis requiring anticoagulant treatment, 2 episodes of hypoxemia and hypotension, and 1 episode of serum sickness. Minor complications occurred in 22 additional patients (31%). Twenty-eight patients (39%) had no complications., CONCLUSIONS: The morbidity and mortality of catheter placement and PE are important considerations when PE treatment for clinically suspected TTP-HUS is anticipated.

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