GLIMPSE ON HEMOSTATIC CHANGES PRODUCED BY PLASMAPHERESIS

Hasan Jaleel AL-Shammari, Haider; Saleem Mahmood Al-Niami, Mayada; Mohammad Hasan, Zainab

	GLIMPSE ON HEMOSTATIC CHANGES PRODUCED BY PLASMAPHERESIS
IRAQI JOURNAL OF MEDICAL SCIENCES
Article 1, Volume 7, Issue 4, 2009, Pages 47-60
Authors
Haider Hasan Jaleel AL-Shammari; Mayada Saleem Mahmood Al-Niami; Zainab Mohammad Hasan
Abstract
Background:The basic idea of aphaeresis is efficient removal of a circulating blood component, either cells (Cytopheresis) or plasma solute (plasmapheresis, plasma exchange).Thus, the treatment goal of aphaeresis is to remove the circulating cell or substance directly responsible for the disease process by automated cell separators in that ensure selectively removal of one or more of blood components from the blood and return the remainder to the individual. Plasmapheresis is separation of plasma from blood cells which are returned to the body. It is accompanied by changes in many haemostatic parameters were found when two different replacement fluids were used. Objective:To determine the effect of: 1. Therapeutic Plasma Exchange (TPE) on selected parameters of hemostasis with each Replacement fluid used and comparing between the effects of the two solutions. 2. Total volume of Plasma Exchanged (PE), spacing between sessions and number of sessions on coagulation screening tests. Patients and Methods:This clinico-haematological study was conducted during a period of six months , from February 2004 to July 2004 at the National Blood Transfusion Center / Baghdad & 50 patients underwent Therapeutic Plasma Exchange for various disorders for 3-12 sessions with two different replacement fluids were used & two types of automated blood cell separators(Haemonetics MCS plus & Fresenius AS.TEC 204) were applied. Venous blood samples were collected immediately before & after the first session & after the last session. Control group of 20 persons were included in this study. Results: The changes in Prothrombin Time, Partial Thromboplastin Time, Thrombin Time, Fibrinogen, Platelets count, Haemoglobin and Packed Cell Volume were significant after TPE. There was no significant difference in changes in crystalloid group from that in Fresh Frozen Plasma (FFP) group. In crystalloid group, significant correlation was observed between Prothrombin Time, Activated Partial Thromboplastin Time, Thrombin Time & volume of PE /session, while spacing between sessions and the number of sessions was significantly correlated with Thrombin Time. Plasma fibrinogen concentration and platelets count were decreased in the patients included in this study. Conclusion: There is no significant difference in changes in haemostatic system whether crystalloid or diluted FFP was used as replacement fluid. Thus, crystalloid, solution devoid from coagulation material can be used as a replacement fluid in the TPE if the volume of PE is small which will minimize the usage of blood components as a safer replacement fluid substitute. Key words: fresh frozen plasma, therapeutic plasma exchange.
Keywords
fresh frozen plasma; therapeutic plasma exchange; plasmapheresis

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