MEMBRANE VERSUS CENTRIFUGE BASED THERAPEUTIC PLASMA EXCHANGE.

Introduction:

Therapeutic plasma exchange (TPE) can be performed using either a highly permeable filter with standard multifunctional dialysis equipment (mTPE) or a centrifugation device (cTPE). Although both methods are well established in clinical practice, there have been few randomized comparisons between the two. Therefore, our study aimed to compare the efficacy and tolerability of two commercially available therapeutic apheresis systems: mTPE (Fresenius PF 2000 N 0.3 m² and TPM max 100 mmHg) and cTPE (NIGAL XJC 2000 plasma separator device)

Methods:

This observational study was conducted at Ain Shams University Hospitals, where 40 patients undergoing plasma exchange were recruited and randomized 1:1. 20 patients underwent mTPE, and 20 underwent cTPE. Procedure-related parameters were recorded, including indications for TPE, replacement fluid used, preparation time, priming time, procedure time (total session duration), flow rate, and anticoagulation used. Plasma removal efficiency (%PRE) was also estimated for all patients, and any adverse events were documented for both procedures.

Results:

Our study included 40 patients, 14 of whom were males (35%), with a mean age of 36.6 ± 15.8 years. TPE was performed for various indications across both groups. Both fresh frozen plasma (FFP) and albumin were used as replacement fluids, with FFP being significantly more common in the m-TPE group, while albumin was more frequently used in the c-TPE group. Heparin was the anticoagulant used in all m-TPE patients, whereas sodium citrate was used in the c-TPE group. The preparation and priming times were significantly longer in the m-TPE group compared to the c-TPE group. However, the procedure time was shorter in the m-TPE group, and both the volume removed, and the volume processed were higher in the m-TPE group compared to the c-TPE group. Plasma removal efficiency was comparable between the two groups , with a slight trend favoring c-TPE (33.9±6 % vs 30.8±4.5%, P=0.07). No significant adverse events were reported in either group.

Conclusions:

We conclude that both centrifuge and membrane methods for TPE are comparably efficient. The c-TPE method offers shorter preparation and priming times, while the m-TPE method has a significantly shorter procedure time. Plasma removal efficiency and adverse event rates were comparable between the two methods

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.