Effects of replacement fluids on coagulation system used for therapeutic plasma exchange

• Published in: Transfusion and apheresis science 2003-02, Vol.28 (1), p.3-7
• Main Authors: Tek, Ibrahim, Arslan, Önder, Arat, Mutlu, Özcan, Muhit, Akdağ, Beyza, İlhan, Osman
• Format: Article
• Language: English
• Subjects: Adult; Aged; Blood Coagulation - drug effects; Blood Coagulation Factor Inhibitors - analysis; Blood Coagulation Factors - analysis; Blood Coagulation Tests; Blood Substitutes - pharmacology; Coagulation factors; Female; Health technology assessment; Humans; Hydroxyethyl Starch Derivatives - pharmacology; Male; Middle Aged; Plasma; Plasma exchange; Plasma Exchange - methods; Plasma Exchange - standards; Replacement solutions; Serum Albumin - pharmacology; Time Factors
• ISSN: 1473-0502; 1878-1683
• DOI: 10.1016/S1473-0502(02)00093-9

Therapeutic apheresis is a widely used treatment alternative for several diseases. In 29 patients with different diseases, we have monitored the PT, aPTT, thrombin time (TT), fibrinogen, D-dimer, factor VIII, IX, X, XI, XII, VWF, Protein C, S, Active Protein C Resistance (APCR) and Antithrombin-III during TPE. Patients were divided into four groups based on the replacement fluids used: 3% VARIHES or ISOHES+4% albumin (1:1) (group 1), fresh frozen plasma (FFP) (group 2), 3% VARIHES or ISOHES (group 3) and 4% albumin (group 4). In our study, the fibrinogen level decreased to 83% of the base line level after the end of 48 h therapy. The APTT, PT, and TT increased during TPE. However no statistical difference was observed between the groups. We found a significant change in factor levels with time, only the difference in factors IX and XI between the groups was significant. In addition, factor levels measured at 48 h were close to the levels measured before aphereses. In our study, time the related change in AT-3 values was significant. Time-related changes of the Protein S and APCR were not statistical significant significant but on the other hand, we found a significant difference in AT-III and Protein C values between groups. The side effects of HES on coagulation factors and tests were comparable to those of other replacement fluids. Its low cost makes it favourable.