title: A retrospective study of complications of therapeutic plasma exchange in myasthenia.
abstract: BACKGROUND
  Venous access for therapeutic plasma exchange (TPE) in myasthenia gravis (MG) can be achieved by central venous catheters (CVC) or peripheral veins (PV), and the preferred method varies among providers. We evaluated our institutional experience with TPE venous access method and complications.
  
  
  METHODS
  We reviewed all TPE-treated MG patients (2005-2010) through blinded chart review. TPE complications were categorized as serious or minor. Serious complications ended the procedure and/or were potentially life-threatening.
  
  
  RESULTS
  A total of 134 MG patients received 230 TPE courses; 56% were outpatient procedures. Whenever feasible, TPE was performed by PV access, which was successful in 75% of courses. Over 90% in both groups improved after TPE. Compared with PV access, CVCs were associated with more total (68% vs. 35%) and serious complications (41% vs. 4%), including 2 deaths.
  
  
  CONCLUSIONS
  PV access for TPE can be used successfully in most MG patients and may reduce morbidity of the procedure.
authors.affiliation: Division of Neurology, Duke University Medical Center, DUMC 2900, Duke University Medical Center, Durham, North Carolina 27710, USA. jeffrey.guptill@duke.edu
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Guptill
authors.forename: Darlene
authors.initials: D
authors.lastname: Oakley
authors.forename: Maragatha
authors.initials: M
authors.lastname: Kuchibhatla
authors.forename: Amanda C
authors.initials: AC
authors.lastname: Guidon
authors.forename: Lisa D
authors.initials: LD
authors.lastname: Hobson-Webb
authors.forename: Janice M
authors.initials: JM
authors.lastname: Massey
authors.forename: Donald B
authors.initials: DB
authors.lastname: Sanders
authors.forename: Vern C
authors.initials: VC
authors.lastname: Juel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000707:Anaphylaxis / Q000209:etiology; D062905:Central Venous Catheters / Q000009:adverse effects*; D005260:Female; D006461:Hemolysis; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000628:therapy*; D010951:Plasma Exchange / Q000009:adverse effects*; D012189:Retrospective Studies; D016896:Treatment Outcome