Plasmapheresis: A Retrospective Audit of Procedures from a Tertiary Care Center in Southern India

The term plasmapheresis/plasma exchange refers to the removal of the plasma component of blood and its replacement with various fluids. Plasma Exchange (PE) has been used to treat a variety of conditions that are associated with an aberrant immune response. We undertook this retrospective study aiming to look at plasmapheresis procedures conducted in the nephrology department over a fixed time period.

Retrospective analysis of PE procedures from January 2013 to October 2016 was conducted in the nephrology and Intensive Care Unit of a tertiary care teaching hospital. The goal was to achieve a total removal of 150-200 ml/plasma per kg body weight. As replacement, we used a standard protocol of 100 ml of 20% albumin in 1 L of normal saline and 2-3 units of fresh frozen plasma. All results were expressed as mean ± standard deviation and statistical analysis was done using the Student's t-test for continuous and Fisher's exact test for categorical data.

A total of 192 procedures performed on 40 patients (22 males and 18 females). Age ranged from 15 to 79 years with a mean age of 37.5 years. Guillain-Barre syndrome accounted for 67.5% (>two-third of causes) for PE. Vascular access was femoral catheter in 27 (67.5%) and internal jugular catheter in 13 (32.5%). Mild hypotension occurred in 15 procedures (7.8%) of patients and allergic reactions such as rashes and chills occurred in 5 cycles (2.6%). A total of 36 patients (90%) showed significant improvement in condition, 2 did not show any change, while one worsened and one died due to respiratory complications.

Our small series of data of plasmapheresis procedures from nephrology perspective has reaffirmed the safety and efficacy of the therapy in an experienced setup.