Long-term outcomes of thrombotic microangiopathy treated with plasma exchange: A systematic review

American Journal of Hematology
Bashiar ThejeelAinslie M Hildebrand

Abstract

With the adoption of plasma exchange as standard treatment for thrombotic microangiopathy (TMA), more patients are surviving and long-term outcomes have greater relevance. We conducted a systematic review to synthesize and evaluate the quality of evidence on long-term outcomes of TMA among adults treated with plasma exchange and to identify factors that may be associated with a worse long-term prognosis. We searched databases from 1980 to 2013 for eligible articles published in any language. We included studies that reported outcomes in at least ten adults with a history of TMA treated with plasma exchange and at least 6 months of follow-up. We abstracted data in duplicate and assessed the methodological quality of each study using an assessment tool developed based on recommended validity criteria. We screened 6672 articles, reviewed 213, and included 34 studies totaling 1182 patients (study median [range], 24 [10-118]). The mean (or median) follow-up ranged from 6 months to 13 years. The cumulative incidence of relapse and mortality was highly variable and ranged from 3 to 84 and 0 to 61%, respectively. The incidence of other outcomes across 10 studies also varied (outcomes included hypertension, kidney disease, preeclampsia,...Continue Reading

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Citations

Jan 10, 2019·The New England Journal of Medicine·Marie ScullyUNKNOWN HERCULES Investigators
Apr 13, 2019·Expert Review of Clinical Pharmacology·Maria Laura Sargentini-MaierHilde De Winter
Jun 30, 2019·European Journal of Haematology·Meera SridharanUNKNOWN Mayo Clinic Complement Alternative Pathway-Thrombotic Microangiopathy Disease-Oriented Group
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Apr 10, 2021·The Journal of Pediatrics·Francesca MinoiaUNKNOWN MAS/sJIA Working Group of the Pediatric Rheumatology European Society (PReS)

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