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Published on: March 14, 2017
Successful reduction of plasma free-hemoglobin using therapeutic plasma exchange: A case report
Chelsea Hayes1, Hedyeh Shafi1, Holli Mason1
1Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Abstract:
Massive intravascular hemolysis may overwhelm hemoglobin (Hgb) clearance mechanisms leading to accumulation of excess plasma free-Hgb and subsequent acute kidney injury. We present the case of a 44-year-old male with cardiac failure necessitating placement of a subcutaneous left ventricular assist device. Following insertion, the patient developed mechanical hemolysis and an acute decline in renal function. Three therapeutic plasma exchange procedures were performed resulting in a dramatic decrease in plasma free-Hgb levels and stabilization of renal function. This demonstrates that therapeutic plasma exchange can be used to decrease plasma free-Hgb in cases of intravascular hemolysis, possibly protecting the patient from hemoglobinuric acute kidney injury.
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