Complications of therapeutic plasma exchange

We reviewed complications associated with 1211 therapeutic plasma exchanges done on 132 patients. Complications were encountered during 148 (12%) procedures and involved 64 (48.5%) patients. Most of the complications were minor in nature but in 17 (12.9% of patients) cases the patient developed serious or potentially serious complications. In 12 cases it was serious enough to terminate the procedure. Most of the complications were due to adverse reactions to the replacement fluid. Twenty-seven (2.2%) procedures were complicated by technical problems. The relatively low rate of serious complications in our series may be due to careful observation of the patients during and after the procedure.