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Therapeutic Plasma Exchange: Core Curriculum 2023.
C Elena Cervantes1, Evan M Bloch2, C John Sperati1
1Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Summary
Therapeutic plasma exchange (TPE) is vital for treating diseases by removing harmful substances. Nephrologists play a key role in managing TPE, utilizing familiar hemodialysis technology for patient care.
Area of Science:
- Nephrology
- Hematology
- Immunology
Background:
- Apheresis, including therapeutic plasma exchange (TPE), is crucial in modern medicine for blood component production and pathogen removal.
- TPE, a procedure involving plasma removal and replacement, offers life-saving benefits for various conditions.
- Nephrologists frequently manage TPE due to its technical similarities with hemodialysis and its relevance in kidney diseases.
Purpose of the Study:
- To provide nephrologists with a comprehensive understanding of therapeutic plasma exchange (TPE).
- To review the technologies, therapeutic approaches, indications, and potential complications of TPE.
- To discuss the application and controversies of TPE in nephrology, particularly in kidney diseases.
Main Methods:
- The review synthesizes information on TPE technologies, including centrifugation and membrane separation.
- It examines the indications for TPE, with a focus on kidney-related diseases and autoantibody-associated conditions.
- The management and clinical considerations of TPE from a nephrologist's perspective are discussed.
Main Results:
- TPE utilizes established technologies, some compatible with hemodialysis machines.
- Certain kidney diseases, like anti-glomerular basement membrane disease, are potential candidates for TPE.
- Evidence supporting TPE use in many kidney diseases remains limited and controversial.
Conclusions:
- Nephrologists require thorough knowledge of TPE for effective patient management.
- Familiarity with TPE technology and its application in kidney diseases is essential for nephrology practice.
- Further research is needed to clarify the role and efficacy of TPE in various nephrological conditions.
Keywords:
Therapeutic plasma exchange (TPE)albuminanti-GBM diseaseanticoagulationapheresisextracorporeal therapiesfrozen plasmaglomerular basement membrane (GBM)intoxicationkidney transplantationplasmapheresisreplacement fluidreviewthrombotic microangiopathy (TMA)vasculitisMore Related Videos
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