Journal
JOURNAL OF CLINICAL APHERESIS
Volume 36, Issue 5, Pages 777-779Publisher
WILEY
DOI: 10.1002/jca.21920
Keywords
multi-organ failure syndrome; sickle cell disease; therapeutic plasma exchange
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Funding
- NHLBI NIH HHS [P01 HL149626] Funding Source: Medline
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Therapeutic plasma exchange (TPE) has shown efficacy in treating MOFS in SCD patients, leading to clinical improvements and reduced mortality rates. There is evidence supporting the inclusion of MOFS secondary to acute SCD as an indication for TPE treatment.
Acute multiorgan failure syndrome (MOFS) remains a significant cause of mortality in sickle cell disease (SCD) patients despite red cell exchange (RCE). In small case series and reports, therapeutic plasma exchange (TPE) has shown benefit in MOFS. As further support for consideration of this modality, we present two patients with SCD and MOFS refractory to RCE who were subsequently treated with TPE. Fresh frozen plasma was used as the replacement fluid. Despite estimated hospital mortality of 40% at the time of intensive care unit admission, both patients showed marked clinical improvement with TPE treatment. Our cases add to the evidence supporting the potential inclusion of MOFS secondary to acute SCD as an indication for TPE in the next edition of the American Society of Apheresis Guidelines on the Use of Therapeutic Apheresis in Clinical Practice.
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