التفاصيل البيبلوغرافية
| العنوان: |
Indications for and outcomes of therapeutic plasma exchange after cardiac transplantation: A single center retrospective study. |
| 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. |
| المصدر: |
Journal of Clinical Apheresis; Aug2018, Vol. 33 Issue 4, p469-479, 11p |
| مستخلص: |
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. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
