دورية أكاديمية
Indications for and outcomes of therapeutic plasma exchange after cardiac transplantation: A single center retrospective study.
| العنوان: | Indications for and outcomes of therapeutic plasma exchange after cardiac transplantation: A single center retrospective study. |
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| المؤلفون: | Onwuemene, Oluwatoyosi A, Grambow, Steven C, Patel, Chetan B, Mentz, Robert J, Milano, Carmelo A, Rogers, Joseph G, Metjian, Ara D, Arepally, Gowthami M, Ortel, Thomas L |
| بيانات النشر: | Wiley |
| سنة النشر: | 2023 |
| المجموعة: | Duke University Libraries: DukeSpace |
| مصطلحات موضوعية: | Humans, Antibodies, HLA Antigens, Plasma Exchange, Heart Transplantation, Survival Analysis, Retrospective Studies, Follow-Up Studies, Adult, Aged, Middle Aged, Female, Male |
| الوصف: | INTRODUCTION:Limited data are available describing indications for and outcomes of therapeutic plasma exchange (TPE) in cardiac transplantation. METHODS:In a retrospective study of patients who underwent cardiac transplantation at Duke University Medical Center from 2010 to 2014, we reviewed 3 TPE treatment patterns: a Single TPE procedure within 24 h of transplant; Multiple TPE procedures initiated within 24 h of transplant; and 1 or more TPE procedures beginning >24 h post-transplant. Primary and secondary outcomes were overall survival (OS) and TPE survival (TS), respectively. RESULTS:Of 313 patients meeting study criteria, 109 (35%) underwent TPE. TPE was initiated in 82 patients within 24 h, 40 (37%) receiving a single procedure (Single TPE), and 42 (38%) multiple procedures (Multiple TPE). Twenty-seven (25%) began TPE >24 h after transplant (Delayed TPE). The most common TPE indication was elevated/positive panel reactive or human leukocyte antigen antibodies (32%). With a median follow-up of 49 months, the non-TPE treated and Single TPE cohorts had similar OS (HR 1.08 [CI, 0.54, 2.14], P = .84), while the Multiple and Delayed TPE cohorts had worse OS (HR 2.62 [CI, 1.53, 4.49] and HR 1.98 [CI, 1.02, 3.83], respectively). The Multiple and Delayed TPE cohorts also had worse TS (HR 2.59 [CI, 1.31, 5.14] and HR 3.18 [CI, 1.56, 6.50], respectively). Infection rates did not differ between groups but was independently associated with OS (HR 2.31 [CI, 1.50, 3.54]). CONCLUSIONS:TPE is an important therapeutic modality in cardiac transplant patients. Prospective studies are needed to better define TPE's different roles in this patient population. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/octet-stream |
| اللغة: | English |
| تدمد: | 0733-2459 1098-1101 |
| العلاقة: | Journal of clinical apheresis; https://hdl.handle.net/10161/27018Test |
| الإتاحة: | https://hdl.handle.net/10161/27018Test |
| رقم الانضمام: | edsbas.7D31EDA1 |
| قاعدة البيانات: | BASE |
| تدمد: | 07332459 10981101 |
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