Therapeutic plasma exchange in heart transplantation: role of coagulation assessment with thromboelastometry

JA Clinical Reports
Andrew CrabbeKenichi A Tanaka

Abstract

Therapeutic plasma exchange (TPE) is a potentially life-saving procedure which effectively removes donor-specific human leukocyte antigen (HLA) antibodies from the bloodstream, allowing critically ill heart transplant recipients to receive a donor organ with less wait time, and reducing the risk of acute organ rejection. The bulk of coagulation factors is initially removed from the blood during TPE using albumin and is later replaced with allogeneic plasma. Coagulopathy may develop during TPE and then can persist due to intraoperative blood loss and hemodilution during surgery and cardiopulmonary bypass. We hereby describe the utility of rotational thromboelastometry to assess rapid coagulation changes during TPE and subsequent heart transplant (HT) surgery.

References

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Citations

Dec 12, 2018·Journal of Clinical Apheresis·Theoni Kanellopoulou, Theodora Kostelidou
Mar 13, 2021·Cardiac Failure Review·Aniket S RaliArthur W Bracey
Oct 4, 2017·British Journal of Anaesthesia·E R StraussK A Tanaka

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