Therapeutic Plasma Exchange in Tehran Between 2011 and 2014
Azita Chegini1, Mehran Moghadami2, Amir H Maghary3
1Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.
Summary
Therapeutic plasma exchange (TPE) is a vital treatment for removing harmful substances. Neurological and hematological conditions like myasthenia gravis and TTP were the most common reasons for TPE, with most procedures being appropriate.
Area of Science:
- Medical Science
- Hematology
- Neurology
Background:
- Therapeutic plasma exchange (TPE) aims to remove pathogenic molecules, autoantibodies, and other harmful substances from the blood.
- Understanding the most common indications for TPE and patient outcomes is crucial for optimizing its use.
Purpose of the Study:
- To identify the most frequent indications for therapeutic plasma exchange (TPE).
- To determine the rate of intensive care unit (ICU) admission among patients undergoing TPE.
- To assess the appropriateness of TPE requests based on established guidelines.
Main Methods:
- A retrospective study was conducted from 2011 to 2014, analyzing data from 1069 inpatients who underwent TPE.
- Patients were categorized into five groups based on TPE indications: hematological/oncological, neurological, renal, rheumatological, and other diseases.
- Data on TPE procedures, patient demographics, ICU admissions, and indication appropriateness (ASFA categories I/II) were collected and analyzed.
Main Results:
- A total of 6329 TPE procedures were performed on 1069 patients (44.8% male, 55.2% female; age range 2-93 years).
- 38.8% of patients were admitted to the ICU.
- Neurological diseases (e.g., myasthenia gravis, Guillain-Barré disease, multiple sclerosis) were the most common indications, followed by hematological (e.g., thrombotic thrombocytopenic purpura - TTP) and renal diseases. 82.97% of TPE requests were deemed appropriate (ASFA categories I/II).
Conclusions:
- Neurological and hematological conditions, particularly myasthenia gravis and TTP, are the leading indications for TPE.
- A significant proportion of patients undergoing TPE require ICU admission, highlighting the severity of their underlying conditions.
- The majority of TPE procedures performed in this cohort met established appropriateness criteria (ASFA I/II).
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