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Anticoagulant regimens for different therapeutic plasma exchange modes
Ruishan Yao1, Haiyan Huang1, Yaohui Ming1
1Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Frontiers in Medicine
|July 3, 2025
Summary
Selecting the right anticoagulant for therapeutic plasma exchange (TPE) is vital for preventing circuit clotting. This review guides clinicians on choosing between heparin and citrate for TPE procedures.
Area of Science:
- Clinical Practice
- Hematology
- Nephrology
Background:
- Therapeutic plasma exchange (TPE) is a critical extracorporeal procedure used across various medical disciplines.
- Effective anticoagulation is essential for preventing circuit thrombosis during TPE, ensuring treatment efficacy and safety.
- Heparin and citrate are the primary anticoagulants employed in TPE, each with distinct characteristics.
Purpose of the Study:
- To review and synthesize current evidence on anticoagulant selection for therapeutic plasma exchange.
- To provide clinicians with data-driven guidance for choosing appropriate anticoagulants based on TPE modality and patient factors.
Main Methods:
- Systematic review of relevant research findings on anticoagulants used in TPE.
- Comparative analysis of heparin and citrate anticoagulation strategies in centrifugal TPE (cTPE) and membrane TPE (mTPE).
- Evaluation of advantages, disadvantages, and complications associated with different anticoagulant regimens.
Main Results:
- Different anticoagulant regimens (heparin vs. citrate) present unique benefits and risks during TPE.
- The choice of anticoagulant is influenced by the specific TPE mode (cTPE or mTPE) and potential patient complications.
- Evidence supports tailored anticoagulant selection to optimize TPE circuit patency and patient safety.
Conclusions:
- Appropriate anticoagulant selection is paramount for successful therapeutic plasma exchange.
- Clinicians should consider the specific TPE method and patient profile when choosing between heparin and citrate.
- Further research may refine anticoagulant protocols for enhanced TPE safety and efficiency.
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