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Preparing your E-Poster
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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Therapeutic plasma exchange (TPE) is used to remove abnormal proteins, antibodies or other harmful molecules from plasma and then return replacement fluid into the blood flow. American Society of Apheresis has reviewed 91 conditions/diseases assigning them category and grade recommendations for TPE. The most common conditions include thrombotic thrombocytopenic purpura (TTP), Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, myasthenia gravis, and ANCA associated vasculitis. In Croatia, TPE procedures are perscribed by the nephrologists and provided by nephrology nurses. We wanted to give a short review of TPE indications and differences in 3 University hospital centers and one University hospital in different parts of Croatia.
Data of TPE patients and TPE indications in the last 5 years were collected from 4 major hospitals in Croatia with air distances from 7 to 259 kilometers: Dubrava University Hospital (A), Sestre Milosrdnice University Hospital Center (B), Clinical Hospital Center Rijeka (C) and University Hospital Center Split (D).
Most of the patients were treated in hospital D (169), following with hospital A (83), hospital B (70) and hospital C (52). When averaged by the hospital bed capacity almost three times more patients were treated with TPE in hospital A than in hospital C (if 5 patients were treated in hospital C, then 6 patients were treated in hospital B, 11 patients in hospital D and 13,4 patients in hospital A). The most common indications were in hospital A, Guillain-Barré syndrome (17%) and ANCA-associated vasculitis (17%), in hospital D, Guillain-Barré syndrome (37%), in hospital C thrombotic microangiopathies (TMA) (15%) and in hospital B hyperviscosity syndrome (multiple myeloma) (21%). When the indications were grouped together by medical specialty area, the results were even more diverse. Hospital A had similar distribution between hematological (26,5%), nephrological (23%) and neurological (27,7%) indications, while hospital D had the vast majority of neurological indications (76,3%) with low hematological (11,2%) and nephrological indications (5,9%). Hospital C had the most hematological indications (31%), with the same distribition between nephrological and neurological indications (13,5%). Hospital B had the most hematological (47,1%) and neurological indications (35,7%). Most patients with nephrological indications both by percent (23%) and apsolute number (22 patients) were treated in hospital A. Hepatic indications for TPE were mostly present in hospitals A (11%) and C (15,4%), and raising in numbers in the last year. In hospitals A and C, 9% of TPE indications were endocrinological (hypertriglyceridemia and thyretoxicosis).
This article shows the diversity of indications for TPE in different hospitals in Croatia. Probably depending on the advancement and enthusiasm of different medical specialities who will call for a nephrology consult. Raising awareness for TPE indications is essential. Further assessment of this data will give input in outcomes.
