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Unintentional platelet removal by plasmapheresis.
J J Perdue1, L K Chandler, S K Vesely
1Hematology-Oncology Section, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73190, USA.
Journal of Clinical Apheresis
|December 18, 2001
Summary
Therapeutic plasmapheresis can unintentionally remove platelets, potentially leading to misdiagnosis. Different apheresis instruments show significant variations in platelet loss during treatment.
Area of Science:
- Hematology
- Nephrology
- Transfusion Medicine
Background:
- Therapeutic plasmapheresis is used to treat various conditions by removing plasma.
- Unrecognized platelet loss during apheresis can complicate patient assessment and treatment.
- A case of thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS) highlighted potential issues with persistent thrombocytopenia interpretation.
Observation:
- A systematic study investigated platelet loss during plasmapheresis procedures.
- Data were collected from 432 apheresis procedures across 71 patients and six disease categories.
- Three different apheresis instruments were evaluated for their impact on platelet counts.
Findings:
- Significant differences in platelet loss were observed among apheresis instruments (P<0.001).
- The Fresenius AS 104 resulted in greater platelet loss (17.5%) compared to COBE Spectra (1.6%) and Haemonetics LN9000 (2.6%).
- Patients with dysproteinemias treated for hyperviscosity experienced higher platelet loss.
Implications:
- Accurate assessment of platelet counts is crucial during plasmapheresis to avoid misinterpreting apheresis-induced thrombocytopenia as active disease.
- Instrument selection in plasmapheresis may influence the degree of platelet removal.
- Further research is needed to optimize apheresis protocols to minimize unintended platelet loss.