Therapeutic plasma exchange experience in internal medicine clinics: a retrospective review of 1,048 procedures

Introduction: Therapeutic plasmapheresis (TP) has been successfully used to treat various internal diseases. In this study, we examined data from the internal medicine clinics at the blood center of Dokuz Eylul University Hospital for patients who underwent plasmapheresis between 2010 and 2014. Methods: In our study, 105 patients who underwent plasmapheresis treatment at the Department of Internal Medicine at Dokuz Eylül University Hospital between January 2010 and December 2014 and a total of 1048 plasmapheresis procedure information were examined. We analyzed the plasmapheresis records obtained from the blood center retrospectively. Data collected included the patient's treatment unit, diagnosis, procedure date, age, height, weight, vascular access route and location, replacement fluids used during plasmapheresis, blood types, and any complications that arose during the procedure. Results: The nephrology clinic conducted a total of 49 procedures, while the hematology clinic completed 21. In the nephrology clinic, the most common patients treated were those with acute rejection, whereas the hematology clinic primarily treated patients diagnosed with thrombotic thrombocytopenic purpura(TTP). Analysis of the procedures indicated that TTP patients had the best response to treatment, followed by those with acute rejection, multiple myeloma, vasculitis, and hyperlipidemia. Most procedures utilized fresh frozen plasma as the replacement fluid. Complications were infrequent and generally mild, with only one death reported. Three different plasmapheresis devices were employed: Astec, Comtec, and Optia. The Comtec device was the most frequently used, serving 63 patients. It showed advantages in terms of shorter treatment times, fewer complications, and improved response rates. Discussion and conclusion: While there are many articles on plasmapheresis, internal medicine clinics have limited experience data. Additionally, comparative data on plasmapheresis-based devices are scarce in the literature. Our study may provide a reference for future research.