Intercambio plasmático terapéutico por plasmafiltración: experiencia de 11 años de un centro

• Gonzalo Ramírez-Guerrero ; Hans Müller-Ortiz ^[1] ; Fernando Jara-Vilugrón ; Cristian Pedreros-Rosales ; Aldo Vera-Calzaretta ; Alexis González-Burboa ; Juan Pablo Silva ; Vicente Torres-Cifuentes ; Francisco Villagrán-Cortés
  1. [1] Universidad de Concepción Hospital Las Higueras Unidad Docente Asistencial
• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 150, Nº. 2, 2022, págs. 147-153
• Idioma: español
• Títulos paralelos:
  • Therapeutic plasma exchange. Experience in 102 patients
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• Resumen

  • Background: Therapeutic Plasma Exchange (TPE) is a procedure in which plasma and harmful macromolecules are separated from the rest of the blood components by centrifugation or filtration through membranes and are replaced with solutions with albumin and/or plasma. Aim: To communicate our experience using TPE by filtration. Material and Methods: Review of records of 655 TPE sessions performed in 102 patients aged 50 ± 18 years (64% women). The requirement of renal replacement therapy (RRT) and seven days and one year mortality were recorded. Results: Forty five percent of patients had hypertension or diabetes. The main indications for TPE were pulmonary-renal syndrome (PRS) (62%) and antibody mediated graft rejection (29%), followed by neurological diseases (36%). Fifteen percent of patients required RRT for one year. Mortality at seven days and one year was 20 and 30%, respectively. Out of the total of deaths associated with kidney diseases, 88% corresponded to PRS and ANCA vasculitis. The main complications were thrombocytopenia in 41%, hypocalcemia in 18%, and hypotension in 16%. Conclusions: In our experience, TPE by filtration is a safe technique, with mild and preventable complications. Despite this, the reported mortality is high, which reflects the severity of the diseases that motivated the indication for TPE.