Oct

6

2021

How is plasma exchange tapered in thrombotic thrombocytopenic purpura (TTP)?

By William Aird

2019 Guidelines on the Use of Therapeutic Apheresis in Clinical Practice:

[Plasma exchange] is generally performed daily until the platelet count is >150 × 109/L, and LDH is near normal for 2-3 consecutive days. The role of tapering therapeutic plasma exchange (TPE) over longer duration has not previously been studied prospectively but is currently being reviewed. A small retrospective study suggests a lower overall recurrence rate at 6 months with taper. A common taper strategy is three times a week for the first week, twice weekly the second and then once weekly the following week(s). Other taper approaches have been documented.