Complications of apheresis.
In general, therapeutic apheresis is a relatively safe procedure with the most commonly seen complications caused by citrate-induced hypocalcemia and urticarial reactions to the protein-containing replacement fluid. Depletion coagulopathy and immunoglobulin depletion must be anticipated when albumin is used as the replacement fluid and becomes more profound as the number of treatment increases. The most serious complications are seen when there is an anaphylactoid reaction to the multiple units of fresh frozen plasma required when used as the replacement fluid. The overall incidence of death is 0.05%, but many of these deaths were in patients with severe preexisting conditions in which the apheresis procedure, itself, may not have been the precipitating cause. As with all extracorporeal treatments requiring large bore vascular access, catheter-related trauma, clotting, infection, and bleeding may also occur.
Division of Nephrology, University of Connecticut Health Center, Farmington, Connecticut 06030, USA. kaplan@nso.uchc.edu
Andre
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Kaplan
D000707:Anaphylaxis / Q000209:etiology* / Q000503:physiopathology; D001424:Bacterial Infections / Q000209:etiology / Q000503:physiopathology; D001778:Blood Coagulation Disorders / Q000209:etiology* / Q000503:physiopathology; D001781:Blood Component Removal / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000209:etiology / Q000503:physiopathology; D007008:Hypokalemia / Q000209:etiology / Q000503:physiopathology; D007022:Hypotension / Q000209:etiology / Q000503:physiopathology; D055370:Lung Injury / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D014777:Virus Diseases / Q000209:etiology / Q000503:physiopathology