Title

Perioperative Applications of Therapeutic Plasma Exchange in Cardiac Surgery: A Narrative Review

Document Type

Journal Article

Publication Date

12-1-2020

Journal

Journal of Cardiothoracic and Vascular Anesthesia

Volume

34

Issue

12

DOI

10.1053/j.jvca.2020.01.054

Keywords

cardiac surgery; coagulation; immunology; plasma exchange

Abstract

Therapeutic plasma exchange (TPE) has a number of applications in cardiac surgical patients and has been used increasingly in high-risk heart and lung transplant patients. In this narrative review, the authors describe TPE principles, complications, and specific indications for TPE, including thrombotic thrombocytopenic purpura, heparin-induced thrombocytopenia, induction of immunotolerance in heart and lung transplant patients, and treatment of antibody-mediated rejection in heart and lung transplant patients. The review is based on published literature and the authors’ institutional experience with perioperative TPE in cardiac surgical patients.

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