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The following is a summary of “Indications and complications associated with centrifuge-based therapeutic plasma exchange – a retrospective review,” published in the February 2025 issue of BMC Nephrology by Warner et al. 

Researchers conducted a retrospective study on Therapeutic Plasma Exchange (TPE) for various disease indications and related complications. TPE was used to manage conditions caused by plasma deficiencies, autoantibodies, alloantibodies, toxins, and immune complexes. 

They conducted a prospective, single-center review of centrifuge-based TPE in 145 patients at a tertiary care academic center from July 2018 to June 2022, including 1,219 TPE treatments. 

The results showed that the most common TPE indications were Antibody-Mediated Rejection (AMR) of a kidney transplant (20%), autoimmune encephalitis (16%), and neuromyelitis optica (11%). Rare indications included Chronic Relapsing Inflammatory Optic Neuropathy (CRION), AMR of a pancreas transplant, osmotic demyelination, and belatacept removal in COVID-19. The most common complications were depletion coagulopathy (47.6%), hypocalcemia (44.1%), and hypokalemia (36.6%), while rare complications included stiff person crisis and pseudohypertriglyceridemia. TPE was used in 31.7% of patients for nephrologist-managed conditions. 

Investigators found that 18.7% of patients received TPE for conditions with an unestablished role, highlighting the need for further research. They also noted that nearly one-third of TPE indications were for nephrologist-managed conditions, supporting its inclusion in nephrology training programs. 

Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-025-03970-2