Scholars@Duke
Oluwatoyosi Adefunke Onwuemene

Oluwatoyosi Adefunke Onwuemene

Associate Professor of Medicine
Medicine, Hematology
toyosi.onwuemene@duke.edu
Box 3422 Med Ctr, Durham, NC 27710
Dept of Medicine, Durham, NC 27710

Scholarly Works

Postpartum Readmission for Pregnancy-Associated Thrombotic Microangiopathy Is Associated With Poor Maternal Outcomes.

Journal article J Clin Apher · February 2026 The postpartum period represents a high-risk interval for presentation with a pregnancy-associated thrombotic microangiopathy (TMA). Given the possibility of immune thrombotic thrombocytopenic purpura, postpartum TMA is typically treated with initiation of ... Full text Link to item Cite

In patients with suspected thrombotic thrombocytopenic purpura, what is the optimal time to therapeutic plasma exchange?

Journal article Hematol Transfus Cell Ther · 2026 BACKGROUND: In patients with suspected immune thrombotic thrombocytopenic purpura, guidelines suggest that therapeutic plasma exchange should be initiated within eight hours. However, this time threshold may be difficult to attain. This study sought to ide ... Full text Link to item Cite

The THINK-TTP Study for Assessing Cognitive Function in Clinical Trials: A Qualitative Research Protocol

Journal article International Journal of Qualitative Methods · January 1, 2026 Purpose of the Research: Immune thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening condition with long-term impacts on survivors’ health-related quality of life (HRQoL). A top HRQoL concern among TTP survivors is cognitive dysfunction. H ... Full text Cite

PRIDE-FTG advances academic careers of underrepresented early-stage investigators performing blood disorders research.

Journal article Blood Adv · August 12, 2025 Despite improvements in the diversity of the US biomedical research workforce, individuals from different racial/ethnic groups remain underrepresented. Even though mentoring is critical for career advancement, underrepresented faculty have limited opportun ... Full text Link to item Cite

Developing A Model to Predict Major Bleeding Among Hospitalized Patients Undergoing Therapeutic Plasma Exchange.

Journal article J Clin Apher · April 2025 Although therapeutic plasma exchange (TPE) can be associated with bleeding, there are currently no known strategies to reliably predict bleeding risk. This study developed a TPE bleeding risk prediction model for hospitalized patients. To develop the predi ... Full text Link to item Cite

Managing surgical relapse risk in acquired thrombotic thrombocytopenic purpura: a systematic review.

Journal article Res Pract Thromb Haemost · July 2024 •Thrombotic thrombocytopenic purpura (TTP) may relapse after surgery.•In a systematic review, we assessed preoperative TTP prophylaxis.•Pre-emptive ADAMTS-13 activity measurement prior to surgery may improve relapse risk.•Preoperative TTP prophylaxis may l ... Full text Link to item Cite

Surprise diagnosis of acquired von Willebrand syndrome in a patient previously thought to have type III von Willebrand disease: evaluation and periprocedural management.

Journal article BMJ Case Rep · December 6, 2023 Acquired von Willebrand syndrome (AVWS) is a rare disorder that is characterised by an acquired deficiency of von Willebrand factor. AVWS was suspected in a patient with type III von Willebrand disease (VWD) who did not respond to factor replacement therap ... Full text Open Access Link to item Cite

In hospitalized patients undergoing therapeutic plasma exchange, major bleeding prevalence depends on the bleeding definition: An analysis of The Recipient Epidemiology and Donor Evaluation Study-III.

Journal article J Clin Apher · December 2023 BACKGROUND: Major bleeding in patients undergoing therapeutic plasma exchange (TPE) has been studied in large databases; but without standardizing bleeding definitions. Therefore, we used standardized definitions to evaluate major bleeding in hospitalized ... Full text Link to item Cite

Patient-Reported Outcome Measures in Patients with Thrombotic Thrombocytopenic Purpura: A Systematic Review of the Literature.

Journal article J Clin Med · August 7, 2023 Health-related quality of life (HRQoL) impacts of thrombotic thrombocytopenic purpura (TTP) have been captured in clinical studies using patient-reported outcome (PRO) measures (PROMs) that are validated for other diseases. However, the validity evidence t ... Full text Link to item Cite

In patients with suspected immune TTP, admission source impacts hospital length of stay and time to therapeutic plasma exchange impacts clinical outcomes.

Journal article Thromb Res · July 2023 INTRODUCTION: When immune thrombotic thrombocytopenic purpura (TTP) is suspected, outcomes are impacted by time to therapeutic plasma exchange (TPE). We evaluated the impact of time to TPE on outcomes in suspected TTP cases admitted through the Emergency D ... Full text Link to item Cite

Guidelines on the Use of Therapeutic Apheresis in Clinical Practice - Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Ninth Special Issue.

Journal article J Clin Apher · April 2023 The American Society for Apheresis (ASFA) Journal of Clinical Apheresis (JCA) Special Issue Writing Committee is charged with reviewing, updating, and categorizing indications for the evidence-based use of therapeutic apheresis (TA) in human disease. In th ... Full text Link to item Cite

Peer mentoring to support career advancement among underrepresented minority faculty in the programs to increase diversity among individuals engaged in health-related research (PRIDE).

Journal article J Clin Transl Sci · 2023 Although mentoring is critical for career advancement, underrepresented minority (URM) faculty often lack access to mentoring opportunities. We sought to evaluate the impact of peer mentoring on career development success of URM early career faculty in the ... Full text Link to item Cite

Recurrent Cryptogenic Stroke in a Young Woman: Congenital Thrombotic Thrombocytopenic Purpura Unmasked

Journal article Annals of Internal Medicine Clinical Cases · December 1, 2022 Cryptogenic stroke of undetermined cause should warrant an exhaustive neurologic and cardiovascular workup. If no cause is identified, additional investigations should be individualized on the basis of clinical history and objective findings. Herein, we pr ... Full text Open Access Cite

Central venous catheters are associated with thrombosis among adult inpatients undergoing therapeutic plasma exchange.

Journal article J Clin Apher · August 2022 BACKGROUND: For inpatients undergoing therapeutic plasma exchange (TPE) in the United States, the primary mode of venous access is the central venous catheter (CVC). To evaluate the impact of CVC on thrombosis outcomes of patients undergoing TPE, we analyz ... Full text Open Access Link to item Cite

Hemostatic effects of therapeutic plasma exchange: A concise review.

Journal article J Clin Apher · June 2022 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 proc ... Full text Open Access Link to item Cite

Bleeding outcomes of inpatients receiving therapeutic plasma exchange: A propensity-matched analysis of the National Inpatient Sample.

Journal article Transfusion · February 2022 BACKGROUND: Although therapeutic plasma exchange (TPE) is associated with hemostatic abnormalities, its impact on bleeding outcomes is unknown. Therefore, the main study objective was to determine bleeding outcomes of inpatients treated with TPE. STUDY DES ... Full text Open Access Link to item Cite

Activated Coagulation Time and Hepcon Protamine Titration Device to Manage Unfractionated Heparin During Cardiopulmonary Bypass in a Hemophilia A Patient on Emicizumab.

Journal article J Cardiothorac Vasc Anesth · November 2021 In the perioperative management of patients with hemophilia A, emicizumab prevents the accurate measurement of common clotting assays, including the activated clotting time (ACT), which is essential for high-dose heparin monitoring during cardiopulmonary b ... Full text Open Access Link to item Cite

Bleeding is associated with intravenous immunoglobulin and therapeutic plasma exchange use in heparin-induced thrombocytopenia: A propensity matched analysis.

Journal article EJHaem · August 2021 Intravenous immunoglobulin (IVIG) and therapeutic plasma exchange (TPE) are used in select cases with heparin-induced thrombocytopenia (HIT). In a cross-sectional analysis, a propensity matched sample was generated by IVIG or TPE treatment status to assess ... Full text Open Access Link to item Cite

Use of therapeutic plasma exchange in heparin-induced thrombocytopenia: A population-based study.

Journal article J Clin Apher · June 2021 BACKGROUND: Heparin-induced thrombocytopenia (HIT) is characterized by anti-heparin/platelet factor 4 immune complexes, which are removed by therapeutic plasma exchange (TPE). Our main objective was to study TPE outcomes in HIT using a large administrative ... Full text Open Access Link to item Cite

A population-based analysis on the use of therapeutic plasma exchange and intravenous immunoglobulin in heparin-induced thrombocytopenia.

Journal article Thromb Res · May 2021 INTRODUCTION: In heparin-induced thrombocytopenia (HIT), selected patients are treated with therapies directed at the immune response, intravenous immunoglobulin (IVIG) and therapeutic plasma exchange (TPE). To determine IVIG and TPE characteristics and ou ... Full text Open Access Link to item Cite

Clinical outcomes of cardiac surgery patients undergoing therapeutic plasma exchange for heparin-induced thrombocytopenia.

Journal article Vox Sang · February 2021 BACKGROUND AND OBJECTIVES: Heparin-induced thrombocytopenia (HIT) is an antibody-mediated condition that leads to thrombocytopenia and possible thrombosis. Patients with HIT who require cardiac surgery pose a challenge as high doses of heparin or heparin a ... Full text Open Access Link to item Cite

Strategies to Aid Identification of Apheresis PowerFlow Ports: A Case Report.

Journal article J Emerg Nurs · January 2021 INTRODUCTION: The PowerFlow implantable apheresis intravenous port is a venous access device for therapeutic apheresis procedures. In this case review article, we identify key similarities and differences between apheresis PowerFlow ports and traditional p ... Full text Open Access Link to item Cite

The Accuracy of Physical Examination to Diagnose Anemia Among Patients 5 Years of Age or Older: A Systematic Review of the Literature

Conference Blood · November 5, 2020 BACKGROUND: Anemia remains a significant public health challenge, with a disproportionate impact on lower-income patients residing in areas of lesser healthcare resources. These patients frequently share limited access to routine laboratory testing ... Full text Cite

Therapeutic plasma exchange and intravenous immune globulin in the treatment of heparin-induced thrombocytopenia: A systematic review.

Journal article Transfusion · November 2020 BACKGROUND: Immunomodulatory strategies in heparin-induced thrombocytopenia (HIT) include the use of intravenous immune globulin (IVIG) and therapeutic plasma exchange (TPE). The optimal application of these therapies is unknown and outcomes data are limit ... Full text Open Access Link to item Cite

Therapeutic plasma exchange for management of heparin-induced thrombocytopenia: Results of an international practice survey.

Journal article J Clin Apher · October 2019 INTRODUCTION: Anti-heparin/platelet factor 4 antibody immune complexes resulting from heparin-induced thrombocytopenia (HIT) are removed by therapeutic plasma exchange (TPE). We sought to define TPE in HIT practice patterns using an international survey. M ... Full text Open Access Link to item Cite

Effects of therapeutic plasma exchange on anticoagulants in patients receiving therapeutic anticoagulation: a systematic review.

Journal article Transfusion · May 2019 Therapeutic plasma exchange (TPE) removes coagulation proteins, but its impact on therapeutic anticoagulation is unknown. We performed a systematic review of the literature to determine the coagulation effects of TPE in patients receiving systemic anticoag ... Full text Open Access Link to item Cite

Therapeutic white blood cell and platelet depletions using the spectra OPTIA system continuous mononuclear cell protocol.

Journal article J Clin Apher · October 2018 The Spectra Optia apheresis system has only recently been approved by the Food and Drug Administration (FDA) for therapeutic white blood cell (WBC) depletions and is not yet approved for platelet depletions. Prior to FDA-approval of the WBC depletion proto ... Full text Open Access Link to item Cite

Indications for and outcomes of therapeutic plasma exchange after cardiac transplantation: A single center retrospective study.

Journal article J Clin Apher · August 2018 INTRODUCTION: Limited data are available describing indications for and outcomes of therapeutic plasma exchange (TPE) in cardiac transplantation. METHODS: In a retrospective study of patients who underwent cardiac transplantation at Duke University Medical ... Full text Open Access Link to item Cite

ASFA Category IV becomes Category I: Idiopathic thrombotic thrombocytopenic purpura in a patient with presumed gemcitabine-induced thrombotic microangiopathy.

Journal article J Clin Apher · June 2018 In the implementation of American Society for Apheresis national guidelines, the decision for therapeutic plasma exchange may be confounded by a clinical presentation that fits both a Category I and IV designation. We report the case of a 45-year-old femal ... Full text Open Access Link to item Cite

Human Leukocyte Antigen Sensitization in Solid Organ Transplantation: A Primer on Terminology, Testing, and Clinical Significance for the Apheresis Practitioner.

Journal article Ther Apher Dial · October 2017 The human leukocyte antigen (HLA) system is an important immunologic barrier that must be considered for successful solid organ transplantation. Formation of donor-specific HLA antibodies in solid organ transplantation is an important cause of allograft in ... Full text Open Access Link to item Cite

Role of C1q complement fixing antibody assay in therapeutic plasma exchange management of pediatric cardiac antibody mediated rejection.

Journal article J Clin Apher · August 2017 Pediatric cardiac transplant patients with antibody-mediated rejection (AMR) often undergo therapeutic plasma exchange (TPE) to remove pathologic donor specific antibodies (DSA). In cases where DSA persist, it is unclear how long TPE should be continued. W ... Full text Open Access Link to item Cite

Antibody depletion strategy for the treatment of suspected antibody-mediated rejection in lung transplant recipients: Does it work?

Journal article Clin Transplant · March 2017 BACKGROUND: Donor-specific antibodies (DSAs) after lung transplantation correlate with poor outcomes. The ideal treatment strategy for antibody-mediated rejection AMR is not defined. Our institution implemented an aggressive multimodality protocol for the ... Full text Link to item Cite

Heparin-induced thrombocytopenia: research and clinical updates.

Journal article Hematology Am Soc Hematol Educ Program · December 2, 2016 Heparin-induced thrombocytopenia (HIT) remains an important diagnosis to consider in hospitalized patients developing thrombocytopenia. HIT is an immune-mediated prothrombotic disorder caused by antibodies to platelet factor 4 (PF4) and heparin. Recent bas ... Full text Link to item Cite

The thrombotic microangiopathy Registry of North America: A United States multi-institutional TMA network.

Journal article J Clin Apher · October 2016 The thrombotic microangiopathy (TMA) Registry Network of North America (TRNA) is a collaborative network organized for the purpose of developing a multi-institutional registry and network to conduct clinical studies in a rare patient population. The TRNA w ... Full text Link to item Cite

The Thrombotic Microangiopathy Registry of North America

Conference Blood · December 3, 2015 AbstractThe thrombotic microangiopathies (TMAs) are rare, life-threatening thrombotic disorders of diverse etiologies. Systematic studies of TMA have been difficult to perform due to their rare occurrence, d ... Full text Cite

Systematic review of anticoagulant treatment of catheter-related thrombosis.

Journal article Thromb Res · December 2015 Central venous catheter-related thrombosis (CRT) is a complication seen in patients requiring long-term intravenous access. Treatment of CRT is not standardized and international guidelines for treatment are based on extrapolation of evidence from lower ex ... Full text Link to item Cite

Clinical Use of Anti-Xa Monitoring in Malignancy-Associated Thrombosis.

Conference Thrombosis · 2015 Introduction. Low molecular weight heparin (LMWH) is preferred for malignancy-associated venous thromboembolism (VTE). Many providers monitor LMWH with anti-Xa levels, despite little validation on correspondence with patient outcome. Methods. This is a ret ... Full text Link to item Cite

Postpartum Hemorrhage Management in 2012

Journal article Obstetric Anesthesia Digest · March 2014 Full text Cite

Clinical Use Of Anti-Xa Monitoring In Malignancy-Associated Thrombosis

Journal article Blood · November 15, 2013 AbstractIntroductionLow molecular weight heparin (LMWH) is currently the preferred anticoagulant for malignancy-associated venous thro ... Full text Cite

An Institutional Experience: Correlation Between Absolute Lymphocyte Count and Survival Outcome After Reduced Intensity Conditioning Allogeneic Stem Cell Transplant in Patients with Hematologic Malignancies

Conference Blood · November 16, 2012 AbstractAbstract 4541Background:Allogeneic stem cell transplant (SCT) is currently the standard of ca ... Full text Cite

Postpartum hemorrhage management in 2012: predicting the future.

Journal article Int J Gynaecol Obstet · October 2012 Transfusion therapy in postpartum hemorrhage (PPH) traditionally has been modeled after precedents set in the Vietnam and Korean wars. However, data from recent military combat casualties suggest a different transfusion strategy. Transfusion of packed red ... Full text Link to item Cite

Comparing digital tomosynthesis to cone-beam CT for position verification in patients undergoing partial breast irradiation.

Journal article Int J Radiat Oncol Biol Phys · March 1, 2009 PURPOSE: To evaluate digital tomosynthesis (DTS) technology for daily positioning of patients receiving accelerated partial breast irradiation (APBI) and to compare the positioning accuracy of DTS to three-dimensional cone-beam computed tomography (CBCT). ... Full text Link to item Cite

Assessment of the residual error in soft tissue setup in patients undergoing partial breast irradiation: results of a prospective study using cone-beam computed tomography.

Journal article Int J Radiat Oncol Biol Phys · March 15, 2008 PURPOSE: On-board cone-beam computed tomography (CBCT) provides soft tissue information that may improve setup accuracy in patients undergoing accelerated partial breast irradiation (APBI). We used CBCT to assess the residual error in soft tissue after two ... Full text Link to item Cite

Stage and Treatment Migration in Patients With Stage III Non-Small Cell Lung Cancer

Conference International Journal of Radiation Oncology*Biology*Physics · November 2007 Full text Cite

SU‐FF‐J‐105: Predicting Late Skin Effects Using Digital Infrared Imaging for Breast Cancer Patients Treated with Radiation

Conference Medical Physics · January 1, 2007 Purpose: Establish a methodology based on digital infrared imaging (DII) to predict skin reaction after breast irradiation using the Skin Radiosensitivity Index (SRI) derived from early skin temperature changes. Method and Materials: Five breast cancer pat ... Full text Cite

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Conference International Journal of Radiation Oncology*Biology*Physics · November 2006 Full text Cite

SU‐DD‐A4‐01: Quantifying Skin Effects After Accelerated Partial Breast Irradiation Using Digital Infrared Imaging (DII): Preliminary Feasibility Data

Conference Medical Physics · January 1, 2006 Purpose: Accelerated partial‐breast irradiation (APBI) is an emerging radiation technique that challenges standard whole breast irradiation. The larger fraction sizes used in these hypofractionated schedules may increase the risk of late normal tissue effe ... Full text Cite

SU‐FF‐I‐17: Reduction of Set‐Up Error Using Cone Beam‐CT in Patients Undergoing Partial Breast Irradiation

Conference Medical Physics · January 1, 2006 Purpose: Partial breast irradiation with multiple external beams requires accurate alignment of the target volume and treatment isocenter. On‐board plannar kV/MV imaging can verify set‐up based on boney landmarks. On‐board cone beam CT (CBCT) may provide a ... Full text Cite