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KMID : 0384119900100020471
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Korean Journal of Clinical Pathology
1990 Volume.10 No. 2 p.471 ~ p.482
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Clinical Evaluation for 56 Cases of therapeutic Plasma Exchange
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J. W. Choi
S. H. Kim/J. T. Suh/K. S. Cho/J. K. Lee
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Abstract
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Plasmapheresis or plasma exchange is the procedure to remove various pathogenic material from the circulation of patients and retrasnsfuse the forined elements into the donor with type-specific fresh frozen plasma or albumin for the replacement of the withdrawn plasma. The purpose of plasma exchange is to generally remove the immunoglobulin, immune complex or protein-bound toxic substance which are not able to be removed with the hemodialysis. In order to evaluate the plasma exchange for the clinical application, author examined a total of 147 plasma exchange procedure on 56 different patients of 17 varieties of diseases during the period of 1983-.1989 at Kyung Hee University Hospital. The results are as follows : 1. The patient`s ages ranged from 6 to 67 years and mean of ages was 35 years. 2. There were 19 males and 37 females and sex ratio was 1:2. 3. There were 17 kinds of disease and the most frequent disease was SLE and the decreasing order was HUS, MPGN, paraquat poisoning and GuillainBarre syndrome. 4. The mean amount of exchanged plasma was 1,600 ml and the number of exchange per patients was 2.6 and mean interval of procedure was 2.3 days. 5. Replacement solution used for the withdrawn plasma were fresh frozen plasma, normal saline, stored plasma and mean amount. of FFP used was 1,450 ml per patients. 6. The therapeutic effects of plasma exchange are relatively good in myasthenia gravis, Guillain- Barre syndorme and Rh(-) pregnacy but is not effective in SLE and paraquat poisoning. 7. The most frequent side effects of therapeutic plasma exchange were paresthesia caused by hypocalcemia and allergic reaction. In this study, therapeutic plasma exchange was applied to immunologic disease but therapeutic effects was only expected in the cases of definite indication. Immune suppressive treatment has to be done at the same time because rebound phenomenon is often followed and specific markers of diseases should be tested quantitative by serologic method. human immunoglogulin. When therapeutic plasma exchange has been applied from the 1st to the 4th TPE. it has been found that the acetylcholine receptor antibody titer has been reduced gradually.
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