Plasma exchange therapy in HELLP syndrome: a single-center experience.
OBJECTIVE
The aim of this study was to investigate the effectiveness of plasma exchange therapy in patients with various forms of hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome.


METHODS
During a three-year period, 13 patients with HELLP syndrome were treated with one or two sessions of plasma exchange after delivery. Diagnosis of hemolysis, elevated liver enzymes, and low platelets syndrome was made according to Sibai's criteria, and the severity of illness was categorized according to platelet counts. Among patients, nine were in class-1 and the remaining four were in class-2. Patients with very high levels of aspartate aminotransferase (AST) (>2000 U/L) and lactate dehydrogenase (LDH) (>3000 U/L) were defined as fulminant type (2 cases).


RESULTS
Rapid improvement in platelet counts was observed after treatment with plasma exchange. All patients survived except the two fulminant hemolysis, elevated liver enzymes, and low platelets syndrome cases.


CONCLUSIONS
In our study, plasma exchange therapy was effective in patients with severe hemolysis, elevated liver enzymes, and low platelets syndrome, but fulminant cases did not appear to respond to this therapy.
Bayraktaroğlu
Ziya
Z
Departments of Pediatrics and Transfusion Medicine, Gaziantep University, School of Medicine, Gaziantep, Turkey. bayraktar@gantep.edu.tr
Demirci
Fikret
F
Balat
Ozcan
O
Kutlar
Irfan
I
Okan
Vahap
V
Uğur
Gürol
G
D000293:Adolescent; D000328:Adult; D001219:Aspartate Aminotransferases / Q000097:blood; D001792:Blood Platelets; D005260:Female; D017359:HELLP Syndrome / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D006801:Humans; D045022:Lactate Dehydrogenases / Q000097:blood; D008428:Maternal Mortality; D010951:Plasma Exchange; D011247:Pregnancy; D011256:Pregnancy Outcome; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
D045022:Lactate Dehydrogenases; D001219:Aspartate Aminotransferases