Hemostatic effects of therapeutic plasma exchange: A concise review.

Journal Article (Journal Article;Review)

Therapeutic plasma exchange (TPE) alters the hemostatic balance. Contributing to TPE's hemostatic effects is the mechanical processing of blood in the extracorporeal circuit, circuit anticoagulant, type of replacement fluid, TPE schedule and number of procedures, TPE timing relative to invasive procedures, and removal of nontargeted components such as platelets, coagulation proteins, and cytokines. Although TPE's hemostatic effects are well established, how it impacts the bleeding risk is not clearly understood. In this concise review, we describe the effects of the above TPE-related factors on hemostatic balance, present data on the effects of TPE on blood hemostasis, including its effects on platelet counts and clotting assays, and review the literature on the impact of TPE-induced hemostatic changes on TPE-associated bleeding events. Finally, we discuss risk factors associated with bleeding during TPE and review the literature on TPE-associated hemostatic effects in the pediatric population.

Full Text

Duke Authors

Cited Authors

  • Soares Ferreira Júnior, A; Hodulik, K; Barton, KD; Onwuemene, OA

Published Date

  • June 2022

Published In

Volume / Issue

  • 37 / 3

Start / End Page

  • 292 - 312

PubMed ID

  • 35196407

Electronic International Standard Serial Number (EISSN)

  • 1098-1101

Digital Object Identifier (DOI)

  • 10.1002/jca.21973


  • eng

Conference Location

  • United States