Trends in therapeutic plasma exchange: a single-center evaluation

Area of Science:

• Nephrology
• Hematology
• Critical Care Medicine

Background:

• The evidence supporting therapeutic plasma exchange (TPE) for various conditions is often limited.
• Centers are experiencing a growing variety of indications for TPE, necessitating an inventory of patient populations.

Purpose of the Study:

• To inventory the TPE patient population at a single center over a 7-year period.
• To determine the evolution of indications for TPE.
• To assess treatment response rates and the existing evidence supporting TPE use.

Main Methods:

• A single-center retrospective inventory of adult patients undergoing TPE over 84 months.
• Analysis of TPE indications, treatment sessions, and patient outcomes.
• Correlation of response rates with the level of evidence supporting TPE indications.

Main Results:

• 69 patients underwent 638 TPE sessions across 91 episodes.
• The majority of indications were Level I (59.4%) or Level II (20.3%).
• Response rates were inversely correlated with the level of evidence (Level I: 97.6%, Level II: 71.4%, Level III: 50%, Level IV: 0%).

Conclusions:

• No significant shift in TPE frequency or indication level was observed.
• Controversial TPE indications warrant careful individual evaluation.
• A trial of TPE should not be dismissed solely due to a lack of robust evidence.