Korean J Blood Transfus.  2011 Aug;22(2):161-170.

Analysis of the Adverse Effects Associated with Therapeutic Plasmapheresis

• Min YS
• Kwon SW
• Choe WH
• Kim BJ
• Cho KJ
• Kim SS

Abstract

BACKGROUND
Although therapeutic plasmapheresis (TP) is a useful procedure in removing pathogenic antibodies and toxic substances from the patient, adverse reactions could arise from the use of replacement fluids and anticoagulants. Comprehensive analysis on those adverse effects had been rarely reported in Korea.
METHODS
We retrospectively investigated the clinical records and the TP records from 3,962 TP sessions for 581 patients between January 1995 and October 2008 at Asan Medical Center, and we analyzed the adverse reactions related to TP.
RESULTS
Adverse reactions were seen in 142 patients (24.4%) in 348 TP procedures (8.8%). Citrate toxicity was most frequently seen in 83 procedures (23.9%) followed by chills in 72 procedures (20.7%), allergic reactions in 69 procedures (19.8%) and hypotension in 60 procedures (17.2%). Citrate toxicity, chills and allergic reactions were seen more frequently in the TP procedures using FFP than in the TP procedures using albumin (P=0.001). The prevalence of citrate toxicity was significantly lower in the cases where calcium gluconate was administered (P<0.001), while it was significantly higher in the patients whose hematocrit was below 28.5% (P<0.001). In terms of severity, the mild, moderate and severe adverse reactions were 36.8%, 56.3% and 6.9%, respectively.
CONCLUSION
TP is a relatively safe method of treatment, but it is important to predict and prevent adverse reactions and to respond appropriately to these adverse reactions.

Keyword

Therapeutic plasmapheresis; Adverse effects; Replacement fluids

MeSH Terms

Antibodies
Anticoagulants
Calcium Gluconate
Chills
Citric Acid
Gluconates
Hematocrit
Humans
Hypersensitivity
Hypotension
Plasmapheresis
Prevalence
Retrospective Studies
Antibodies
Anticoagulants
Calcium Gluconate
Citric Acid
Gluconates