Premium
Complications of Apheresis
Author(s) -
Kaplan Andre
Publication year - 2012
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/j.1525-139x.2011.01026.x
Subject(s) - medicine , apheresis , fluid replacement , fresh frozen plasma , coagulopathy , surgery , albumin , clotting factor , plasmapheresis , extracorporeal , vascular access , incidence (geometry) , intensive care medicine , antibody , platelet , immunology , hemodialysis , physics , optics
In general, therapeutic apheresis is a relatively safe procedure with the most commonly seen complications caused by citrate‐induced hypocalcemia and urticarial reactions to the protein‐containing replacement fluid. Depletion coagulopathy and immunoglobulin depletion must be anticipated when albumin is used as the replacement fluid and becomes more profound as the number of treatment increases. The most serious complications are seen when there is an anaphylactoid reaction to the multiple units of fresh frozen plasma required when used as the replacement fluid. The overall incidence of death is 0.05%, but many of these deaths were in patients with severe preexisting conditions in which the apheresis procedure, itself, may not have been the precipitating cause. As with all extracorporeal treatments requiring large bore vascular access, catheter‐related trauma, clotting, infection, and bleeding may also occur.