Frequent use of therapeutic plasmapheresis and advances in medicine and technology generated significant changes in indications, complications, method and epidemiological characteristics of patients treated with this procedure. Nevertheless many questions still remain open.
Database of the National Referral Centre for therapeutic plasmapheresis and apheresis was retrospectively analyzed for changes in indications, complications, method and epidemiological characteristics of patients treated during 27 years of follow-up.
An increase in number of procedures, patients and patients’ age. Neurological indications dominate, with significant changes in spectra of indications. Methods of conducting TPE also changed significantly: there is less use of unfractioned heparin, exchange volumes are larger and use of CVK more frequent. Complications occurred during 10,8 % of TPE. Use of fractionated heparin, fresh frozen plasma resulted in higher percentage of complications. That is also true for procedures done for hematological indications and in chronic program. Use of AV fistula, prophylactic replenishment of potassium and adult
patients had smaller percentage of complications. Complications occurred in 7,4 % of LDL apheresis.
The complexity of procedure, possible complications and high costs, ask to respect, permanently reviewe and update the guidelines for its use. National apheresis registry would contribute to improvement of the quality and safety of therapeutic apheresis and help in identifying best treatment options
