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 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.