Complications of Therapeutic Plasma Exchange in Patients with Neurologic Disorders

Abstract

Background: Therapeutic plasma exchange (TPE) is the treatment of choice for several neurological disorders. However, performing TPE in patients is accompanied by some complications. Objectives: This study investigates the complications caused by TPE in patients with neurological disorders. Methods: This retrospective study was conducted from October 2020 to October 2021 at the Neurology Department of Shariati Hospital, Tehran, Iran, on all patients undergoing TPE for any neurological indication. Data related to complications in TPE patients were collected based on the information in their files. The complications recorded in the patients’ files were documented in the relevant checklist based on the documentation, tests, and clinical examinations that had been performed. Complications were assessed on days 1 and 5 during the TPE procedure. Statistical analysis was performed using IBM SPSS Statistics, version 25. Results: On the first day after TPE, anxiety (P = 0.002) and citrate-induced hypocalcemia (P = 0.012) were observed in 10 (10.5%) and 37 (38.9%) patients, respectively. By the 5th day after TPE, 31 patients (32.6%) experienced albumin depletion (P < 0.001). This was despite the fact that there was no significant relationship in terms of other side effects, including albumin hypersensitivity, homeostasis, vascular access, pain, and cardiac complications, between days 1 and 5 (P > 0.05). Conclusions: The incidence of complications on days 1 and 5 after TPE differs among patients, and their identification can aid in the better management of patients with neurological disorders.