A retrospective study of complications of therapeutic plasma exchange in myasthenia.

INTRODUCTION: Venous access for therapeutic plasma exchange (TPE) in myasthenia gravis (MG) can be achieved by central venous catheters (CVC) or peripheral veins (PV), and the preferred method varies among providers. We evaluated our institutional experience with TPE venous access method and complications. METHODS: We reviewed all TPE-treated MG patients (2005-2010) through blinded chart review. TPE complications were categorized as serious or minor. Serious complications ended the procedure and/or were potentially life-threatening. RESULTS: A total of 134 MG patients received 230 TPE courses; 56% were outpatient procedures. Whenever feasible, TPE was performed by PV access, which was successful in 75% of courses. Over 90% in both groups improved after TPE. Compared with PV access, CVCs were associated with more total (68% vs. 35%) and serious complications (41% vs. 4%), including 2 deaths. CONCLUSIONS: PV access for TPE can be used successfully in most MG patients and may reduce morbidity of the procedure.

Duke Scholars

Author Jeffrey Guptill Neurology, Neuromuscular Disease

Author Maragatha Kuchibhatla Biostatistics & Bioinformatics, Division of Biostatistics

Author Lisa Deneen Hobson-Webb Neurology, Neuromuscular Disease

Author Janice Munn Massey Neurology, Neuromuscular Disease

Author Donald Benjamin Sanders Neurology, Neuromuscular Disease

Author Vern Charles Juel Neurology, Neuromuscular Disease