[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-639934-en":3,"detail-sidebar-cat-0-en-105":31,"doc-seo-639934-105":80},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":21,"is_downloadable":21,"audit_status":21,"page_count":22,"language":23,"language_code":24,"site_id":25,"html_lang":24,"table_of_contents":26,"faqs":27,"seo_title":28,"seo_description":14,"update_tm":29,"read_time":30},639934,18829141979164,"Cart","https://eur-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8",8,"Research & Report","Hemostatic and thrombotic outcomes in patients undergoing therapeutic plasma exchange - Original Research","Whether therapeutic plasma exchange (TPE) causes clinically relevant bleeding or thrombotic events is insufficiently defined. A single-institution retrospective cohort study (2017–2021) evaluated adults receiving TPE with at least three sessions in a 14-day window, using independent chart review. The 30-day cumulative incidence estimated clinically relevant bleeding at 8.0% and thrombosis at 4.0%, with older age and chronic kidney disease linked to higher bleeding risk. Plasma replacement with fresh frozen plasma increased bleeding incidence. TPE bleeding complications occur more often than previously recognized.","Received: 18 January 2025 Revised: 10 May 2025 Accepted: 12 June 2025  \nDOI: 10.1111/trf.18320  \nORIGINAL RES EARCH  \nHe map heresis  \nHemostatic and thrombotic outcomes in patients undergoing therapeutic plasma exchange  \nSirui Ma 1  | Rushad Patell 2 | Laura Dodge 3 | Shengling Ma 4 | Michelle Knox 5 | Brian J. Carney 2  \n1Division of Hematology and Oncology, Department of Medicine, University of California San Francisco, San Francisco, California, USA  \n2Division of Hematology and Hematologic Malignancies, Beth Israel Deaconess Medical Center, Boston,  \nMassachusetts, USA  \n3Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston,  \nMassachusetts, USA  \n4Section of Hematology and Oncology, Baylor College of Medicine, Houston, Texas, USA  \n5Apheresis Services, Beth Israel Deaconess Medical Center, Boston,  \nMassachusetts, USA  \nCorrespondence  \nBrian J. Carney, Division of Hematology and Hematologic Malignancies, Beth Israel Deaconess Medical Center,  \n330 Brookline Avenue, Rabb 430, Boston, MA 02215, USA. [Email:](Email: bjcarney@bidmc.harvard.edu)[ bjcarney@bidmc.harvard.edu](Email: bjcarney@bidmc.harvard.edu)  \nAbstract  \nBackground: Whether therapeutic plasma exchange (TPE) results in clinically relevant bleeding or thrombotic events is not well characterized.  \nStudy Design and Methods: We conducted a single-institution retrospective cohort study to estimate the incidence of bleeding and thrombotic outcomes of patients treated with TPE from 2017 to 2021 . Patients with ≥3 treatment sessions within a 14-day period were included. Two independent physician reviewers manually reviewed patient charts. We calculated the 30-day cumulative incidence of bleeding and thrombotic outcomes with 95% confidence intervals (CI) . We used a regression model to determine the association between clinical and laboratory features and study outcomes.  \nResults: The study comprised 145 patients who underwent 176 treatment courses, representing a cumulative total of 890 individual TPE procedures. The cumulative incidence of clinically relevant bleeding (including major bleeding and clinically relevant nonmajor bleeding) was 8.0%(95% CI 4.4%–13.0%), and thrombosis was 4.0%(95% CI 1.6%–8.0%) . There was one fatal bleeding event. Older age and chronic kidney disease were associated with odds ratios of 1.08 (95% CI 1.03–1.13, p = .002) and 4.68 (95% CI 1.33–14.90, p = .01), respectively, for bleeding. Patients who received any quantity of fresh frozen plasma as replacement fluid had a bleeding rate of 16.4% compared to 6.6% in patients who did not receive plasma (p = .05) .  \nDiscussion: TPE-associated bleeding complications occur at a higher rate than previously understood. Further prospective investigations are merited to characterize bleeding risk factors and optimal preventive strategies.  \nKEYWOR DS  \nhemorrhage, plasma exchange, plasmapheresis, thrombosis, transfusion  \n1 | INTRODUCTION  \nTherapeutic plasma exchange (TPE) describes an apheresis technique of removing whole blood from a patient and separating plasma and cellular components to  \neliminate pathogenic constituents, typically antibodies.1 This process is used to treat a wide range of heterogeneous conditions, driven by evidence-based guidelines from the American Society for Apheresis (ASFA) .2 Effective therapy necessitates the removal of significant  \n1510  \nMA ET AL.  \nplasma volumes, followed by the infusion of a replacement fluid. An expected consequence of TPE is the nonselective depletion of physiologic proteins, causing significant reductions of coagulation factors and natural anticoagulants when nonplasma replacement fluid such as albumin is utilized.3 TPE-induced coagulopathy has been demonstrated across multiple investigations with reports of prolongation of coagulation parameters, diminished factor assay activity, impaired platelet aggregation, and derangements in thromboelastometry.4–6 Inadvertent depletion of platelets by TPE may similarly","cbCaieVKY1FRR7P8","https://ap.wps.com/l/cbCaieVKY1FRR7P8","pdf",660799,2,1,9,"English","en",105,"# Abstract\n## Background\n## Study Design and Methods\n## Results\n## Discussion\n# Introduction\n# Materials and Methods","[{\"question\":\"What is the main research question about therapeutic plasma exchange (TPE)?\",\"answer\":\"Whether TPE leads to clinically relevant bleeding or thrombotic events, since these outcomes are not well characterized.\"},{\"question\":\"How were patients selected and how were outcomes assessed in the study?\",\"answer\":\"Adults who underwent at least three TPE procedures within a 14-day period were included. Two independent physician reviewers manually reviewed patient charts, and 30-day cumulative incidence with 95% confidence intervals was calculated.\"},{\"question\":\"What were the key findings regarding bleeding and thrombosis rates?\",\"answer\":\"Among 145 patients and 176 treatment courses (890 procedures), clinically relevant bleeding occurred in 8.0% and thrombosis in 4.0%, including one fatal bleeding event.\"},{\"question\":\"Which factors were associated with higher bleeding risk in the results?\",\"answer\":\"Older age and chronic kidney disease were associated with increased odds of bleeding. Receiving any fresh frozen plasma as replacement fluid was associated with a higher bleeding rate than not receiving plasma.\"}]","Hemostatic and thrombotic outcomes in patients undergoing therapeutic plasma exchange - Original Research | PDF",1792706172,23,{"code":4,"msg":5,"data":32},[33,38,42,47,52,57,62,65,69,72,76],{"id":21,"doc_module":4,"doc_module_name":34,"category_name":35,"show_sort_weight":36,"slug":37},"Document","Story & Novel",90,"story-novel",{"id":20,"doc_module":4,"doc_module_name":34,"category_name":39,"show_sort_weight":40,"slug":41},"Literature",80,"literature",{"id":43,"doc_module":4,"doc_module_name":34,"category_name":44,"show_sort_weight":45,"slug":46},4,"Exam",70,"exam",{"id":48,"doc_module":4,"doc_module_name":34,"category_name":49,"show_sort_weight":50,"slug":51},5,"Comic",60,"comic",{"id":53,"doc_module":4,"doc_module_name":34,"category_name":54,"show_sort_weight":55,"slug":56},6,"Technology",50,"technology",{"id":58,"doc_module":4,"doc_module_name":34,"category_name":59,"show_sort_weight":60,"slug":61},7,"Healthcare",40,"healthcare",{"id":11,"doc_module":4,"doc_module_name":34,"category_name":12,"show_sort_weight":63,"slug":64},30,"research-report",{"id":22,"doc_module":4,"doc_module_name":34,"category_name":66,"show_sort_weight":67,"slug":68},"Religion & Spirituality",20,"religion-spirituality",{"id":67,"doc_module":4,"doc_module_name":34,"category_name":70,"show_sort_weight":67,"slug":71},"World Cup","world-cup",{"id":73,"doc_module":4,"doc_module_name":34,"category_name":74,"show_sort_weight":73,"slug":75},10,"Lifestyle","lifestyle",{"id":77,"doc_module":4,"doc_module_name":34,"category_name":78,"show_sort_weight":48,"slug":79},19,"General","general",{"code":4,"msg":81,"data":82},"ok",{"site_id":25,"language":24,"slug":83,"title":13,"keywords":84,"description":14,"schema_data":85,"social_meta":143,"head_meta":145,"extra_data":147,"updated_unix":29},"hemostatic-and-thrombotic-outcomes-in-patients-undergoing-therapeutic-plasma-exchange-original-research","",{"@graph":86,"@context":142},[87,101,121],{"@type":88,"itemListElement":89},"BreadcrumbList",[90,94,96,99],{"item":91,"name":92,"@type":93,"position":21},"https://docshare.wps.com","Home","ListItem",{"item":95,"name":34,"@type":93,"position":20},"https://docshare.wps.com/document/",{"item":97,"name":12,"@type":93,"position":98},"https://docshare.wps.com/document/research-report/",3,{"item":100,"name":13,"@type":93,"position":43},"https://docshare.wps.com/document/hemostatic-and-thrombotic-outcomes-in-patients-undergoing-therapeutic-plasma-exchange-original-research/639934/",{"url":100,"name":13,"@type":102,"image":103,"author":108,"headline":13,"publisher":110,"fileFormat":113,"inLanguage":24,"description":14,"dateModified":114,"datePublished":115,"encodingFormat":113,"isAccessibleForFree":116,"interactionStatistic":117},"DigitalDocument",{"url":104,"@type":105,"width":106,"height":107},"https://docshare.wps.com/thumbnails/hemostatic-and-thrombotic-outcomes-in-patients-undergoing-therapeutic-plasma-exchange-original-research/639934.png","ImageObject",300,407,{"name":9,"@type":109},"Person",{"url":91,"name":111,"@type":112},"DocShare","Organization","application/pdf","2026-10-31","2026-10-22",true,{"@type":118,"interactionType":119,"userInteractionCount":20},"InteractionCounter",{"@type":120},"ViewAction",{"@type":122,"mainEntity":123},"FAQPage",[124,130,134,138],{"name":125,"@type":126,"acceptedAnswer":127},"What is the main research question about therapeutic plasma exchange (TPE)?","Question",{"text":128,"@type":129},"Whether TPE leads to clinically relevant bleeding or thrombotic events, since these outcomes are not well characterized.","Answer",{"name":131,"@type":126,"acceptedAnswer":132},"How were patients selected and how were outcomes assessed in the study?",{"text":133,"@type":129},"Adults who underwent at least three TPE procedures within a 14-day period were included. Two independent physician reviewers manually reviewed patient charts, and 30-day cumulative incidence with 95% confidence intervals was calculated.",{"name":135,"@type":126,"acceptedAnswer":136},"What were the key findings regarding bleeding and thrombosis rates?",{"text":137,"@type":129},"Among 145 patients and 176 treatment courses (890 procedures), clinically relevant bleeding occurred in 8.0% and thrombosis in 4.0%, including one fatal bleeding event.",{"name":139,"@type":126,"acceptedAnswer":140},"Which factors were associated with higher bleeding risk in the results?",{"text":141,"@type":129},"Older age and chronic kidney disease were associated with increased odds of bleeding. Receiving any fresh frozen plasma as replacement fluid was associated with a higher bleeding rate than not receiving plasma.","https://schema.org",{"og:url":100,"og:type":144,"og:title":13,"og:site_name":111,"og:description":14},"article",{"robots":146,"canonical":100},"index,follow",{"doc_id":7,"site_id":25}]