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Partial Plasma Exchange, an Adjunct in Therapy to Complex Clinical Problems
Author(s) -
Laningham J. E. T.
Publication year - 1977
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.1977.17678075649.x
Subject(s) - plasmapheresis , cryoprecipitate , fresh frozen plasma , medicine , hyperviscosity syndrome , antibody , hyperviscosity , hematocrit , fibrinogen , surgery , platelet , blood viscosity , anesthesia , gastroenterology , immunology , multiple myeloma
The use of therapeutic partial plasma exchange (PPE) is reviewed as an adjunct in the treatment of certain complex clinical problems. The procedure is performed with a Model 30 Haemonetics Blood Cell Separator in which the patient's plasma is partially exchanged with fresh frozen plasma, fresh frozen plasma with cryoprecipitate removed or with plasma protein fraction. The present study describes the use of PPE on 12 patients within the last IS months as a means of altering the plasma proteins to achieve certain therapeutic goals. The study consists of six procoagulant deficient patients (five congenital and one acquired) in which five of the six patients responded by reflecting a satisfactory rise in the plasma procoagulant level following the procedure, resulting in cessation of bleeding. The sixth patient was thought to have had a procoagulant inhibitor, thus the procoagulant level was changed only minimally. The remaining six patients (live with hyperviscosity syndrome and one with platelet antibody) responded only to the degree of the intensiveness of the PPE procedure. More aggressive, repeated PPE and/or plasmapheresis are needed if the clinical objective is to decrease the plasma viscosity or to lower a humoral antibody within the patient's plasma.