Complications of Plasmapheresis

Common Complications

• Blood pressure instability can occur due to rapid fluid shifts during the procedure, according to the European Respiratory Journal 1, 2
• Removal of clotting factors can lead to coagulation defects, as noted by Praxis Medical Insights 2
• Increased infection risk due to removal of immunoglobulins, as reported by Praxis Medical Insights 2, 3

Severe Complications

• Mortality associated with plasmapheresis is estimated at 0.05% based on systematic reviews, according to the European Respiratory Journal 1
• Pulmonary embolism is a rare but serious potential complication, as noted by the European Respiratory Journal 1
• Transfusion-related acute lung injury (TRALI) can occur, particularly when using fresh frozen plasma, as reported by Critical Care 4

Replacement Fluid-Related Complications

• FFP carries risks of ABO incompatibility, transmission of infectious diseases, and allergic reactions, as noted by Critical Care 4
• Albumin replacement generally has fewer complications but may not replace specific clotting factors, as reported by Critical Care 4

Prevention Strategies

• Careful selection of replacement fluids based on the patient's condition and specific disease being treated, as recommended by Praxis Medical Insights 2
• Timing coordination when used with other therapies, such as rituximab, which should be administered after plasmapheresis since the procedure removes the drug, as noted by Praxis Medical Insights 2

Special Populations

• Benefit-risk assessment should be carefully considered in hemodynamically unstable patients, as recommended by Circulation 5