COST-EFFECTIVE PLASMAPHERESIS: A SINGLE-CENTRE EXPERIENCE OF PLASMA FILTER REUSE FROM EASTERN INDIA

Introduction:

Our center is a nephrology-focused institute serving patients from diverse socio-economic and geographic backgrounds. Only a few studies have shown the safety and efficacy of reusing plasma filters in resource limited setups. In our center, as a protocol, we have been reusing the plasma filter (Fresenius PlasmaFlux P2 dry) after reprocessing it with 4.0% per acetic acid and 20% hydrogen peroxide, with the intention to reduce the cost. Replacement fluid used was Fresh Frozen plasma (FFP), while 5% human albumin was used when there was reaction to FFP, or the exchange volume was large.

The aim of this study was to analyse the indications, demographic profile, and safety profile in patients undergoing therapeutic plasma exchange (plasmapheresis) in our centre within the last one year.

Methods:

Retrospective analysis of the clinical and demographical profile of the patients who underwent plasmapheresis in our center from August 2023- July 2024 was done by using the available digital records. Data was tabulated in MS-Excel and further statistical analysis was done. Clinical indications, number of sessions, replacement fluid, complications and the other demographical parameters were compared. The outcomes after plasmapheresis were also compiled.

Results:

A total of 54 patients underwent a total of 249 sessions in this given period. Majority of them (64.18%) were male. The most common indication for plasmapheresis was as a therapy for Antibody mediated rejection (48.15%) followed by as a part of the pre-transplant desensitization protocol (38.88%). Only 1 patient had non nephrological indication which was a case of LETM NMO spectrum disorder. All the patients underwent a mean 5.04 ± 0.61 number of sessions. Most common adverse event reported was itching (59.25%). Serious events like hypotension were reported in 18.51% cases. All the patients undergoing desensitization were able to undergo successful kidney transplant with no cases of early rejection. Of the patients who underwent plasmapheresis for ABMR or FSGS recurrence 6 patients had graft loss within 3 months of plasmapheresis. Overall cost wise, reusing the plasma filter was approximately 57% cheaper than single use of plasma filter (excluding IVIG or Albumin).

Conclusions:

Reprocessing and reusing the plasma filter is a safe and cost-effective method especially for a resource limited set up however larger comparative studies across multiple indications is required to establish the non-inferiority.

I have no potential conflict of interest to disclose.

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