Therapeutic plasma exchange using apheresis: Clinical experience and outcomes in neurological and non-neurological cases at a tertiary care center in western India

INTRODUCTION: Therapeutic plasma exchange (TPE) is a procedure used to treat various neurological and non-neurological disorders by removing and replacing a patient’s plasma to eliminate disease-causing substances. Here, we present our experience using TPE to treat various diseases with an apheresis...

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Main Authors: Shashikant Baraku Patil, Satyajit Singh Gill, Sandeep Borse, Nilesh Bhandari, Sulaxmi Kurade-Aher
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-07-01
Series:Asian Journal of Transfusion Science
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Online Access:https://journals.lww.com/10.4103/ajts.ajts_195_24
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Summary:INTRODUCTION: Therapeutic plasma exchange (TPE) is a procedure used to treat various neurological and non-neurological disorders by removing and replacing a patient’s plasma to eliminate disease-causing substances. Here, we present our experience using TPE to treat various diseases with an apheresis machine. AIM: To evaluate the safety and efficacy of TPE as a treatment modality in various patients with neurological and non-neurological diseases admitted in tertiary care center in western India. METHODOLOGY: A retrospective analysis of 152 TPE procedures was conducted over 3 years (April 2021–April 2024) in a Western Indian tertiary care hospital. The study involved 39 patients aged 7–72 years. Clinical improvement was assessed through relevant investigations before, during, and after TPE procedures. RESULTS: Thirty-nine patients were studied, with Guillain–Barre Syndrome (GBS) being the most common indication for TPE, followed by acute liver failure (ALF) and myasthenia gravis (MG). Clinical improvement was seen in 76.19% (16/21) of GBS patients, 12.5 (1/8) of ALF, and 100% (5/5) of MG patients. 13/18 (72.22%) patients in the neurological category showed complete recovery even after replacement of 0.5–0.9 plasma volume (n = 18). The adverse reaction rate for TPE was 5.92% (9 events in 152 cycles), most common being allergic reactions and paresthesia. CONCLUSION: TPE is safe and efficient treatment modality for the treatment of neurological and non-neurological diseases. Our experience highlights TPE’s safety and efficacy. One group in the neurological category showed improvement even with low-volume exchanges (0.5–0.9 PV). Further research is required to enhance the understanding and use of TPE in patient care.
ISSN:0973-6247
1998-3565