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New directions in plasma exchange

Winters, J. L.; Pineda, A. A.

Transfusion medicine

Purpose of review This review examines the literature published on therapeutic plasma exchange during 2002. The review was performed by searching Medline for pertinent articles.

Recent findings One hundred thirty articles were identified, of which 11 are reviewed. During the period, reviews of the use of therapeutic plasma exchange for managing Guillain-Barré syndrome and myasthenia gravis were published. A large randomized trial of the use of plasma exchange to treat sepsis also appeared. Finally, a large case series of the use of plasma exchange in Wegener granulomatosis was published.

Summary The literature confirms the use of plasma exchange for Guillain-Barré syndrome but suggests that inadequate evidence exists to support its use for long-term improvement in myasthenia gravis. The study of patients with severe sepsis suggests that plasma exchange may benefit a subset of patients, those with abdominal infections. Finally, plasma exchange for Wegener granulomatosis with severe renal dysfunction appears not to offer any benefit over immunosuppressive therapy.

Department of Laboratory Medicine and Pathology, Mayo Medical School and Division of Transfusion Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA

Correspondence to Alvaro A. Pineda, MD, Mayo Foundation, Division of Transfusion Medicine, 200 1st Street SW, Rochester, MN 55905, USA

E-mail: pineda.alvaro@mayo.edu

© 2003 Lippincott Williams & Wilkins, Inc.