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Therapeutic plasma exchange (TPE) as a plausible rescue therapy in severe vaccine-induced immune thrombotic

Gail Rock1, Viktoria Weber2, Bernd Stegmayr3

  • 1Canadian Apheresis Group, Ottawa, Canada.

Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis
|June 5, 2021
PubMed

Vaccine-induced immune thrombotic thrombocytopenia (VITT) is associated with high titers of immunoglobulin G class antibodies directed against the cationic platelet chemokine platelet factor 4 (PF4). These antibodies activate platelets via FcγIIa receptors. VITT closely resembles heparin-induced thrombocytopenia. Inflammation and tissue trauma substantially increase the risk for forming pathogenic PF4 antibodies. We therefore propose the use of therapeutic plasma exchange as rescue therapy in VITT to deplete antibodies plus factors promoting inflammation such as excess cytokines in the circulation as well as extracellular vesicles derived from activated platelets.

Keywords:
AntibodiesApheresisCovid-19PlateletsTherapeutic plasma exchangeTherapyThrombocytopeniaVITTVaccine-induced immune thrombotic thrombocytopenia

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