Therapeutic plasma exchange in heart transplantation: role of coagulation assessment with thromboelastometry

Therapeutic plasma exchange (TPE) is a potentially life-saving procedure which effectively removes donor-specific human leukocyte antigen (HLA) antibodies from the bloodstream, allowing critically ill heart transplant recipients to receive a donor organ with less wait time, and reducing the risk of acute organ rejection. The bulk of coagulation factors is initially removed from the blood during TPE using albumin and is later replaced with allogeneic plasma. Coagulopathy may develop during TPE and then can persist due to intraoperative blood loss and hemodilution during surgery and cardiopulmonary bypass. We hereby describe the utility of rotational thromboelastometry to assess rapid coagulation changes during TPE and subsequent heart transplant (HT) surgery.

• Publication year

  2016

• Venue

  JA Clinical Reports

• Publication date

  2016-10-19

• Fields of study

  Medicine

• Identifiers
  DOI 10.1186/s40981-016-0058-1PMID 29492426PMCID 5814793
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Ex vivo evaluation of 4 different viscoelastic assays for detecting moderate to severe coagulopathy during liver transplantation

  2016cited by this paper
• Randomized, Double-Blinded, Placebo-Controlled Trial of Fibrinogen Concentrate Supplementation After Complex Cardiac Surgery

  2015cited by this paper
• Survival in Sensitized Lung Transplant Recipients With Perioperative Desensitization

  2015influential reference
• Rapid and correct prediction of thrombocytopenia and hypofibrinogenemia with rotational thromboelastometry in cardiac surgery.

  2014cited by this paper
• Techniques and applications of perioperative therapeutic plasma exchange

  2014influential reference
• Thyroid hormone and the stunned myocardium.

  2014cited by this paper
• Effects of Fibrinogen Concentrate as First-line Therapy during Major Aortic Replacement Surgery: A Randomized, Placebo-controlled Trial

  2013cited by this paper
• Perioperative factor concentrate therapy.

  2013cited by this paper
• The Relationship Between Fibrinogen Levels After Cardiopulmonary Bypass and Large Volume Red Cell Transfusion in Cardiac Surgery: An Observational Study

  2013cited by this paper
• The use of 50% albumin/plasma replacement fluid in therapeutic plasma exchange for thrombotic thrombocytopenic purpura

  2013cited by this paper
• Diagnosis of perioperative coagulopathy--plasma versus whole blood testing.

  2013cited by this paper
• Plasma exchange: concepts, mechanisms, and an overview of the American Society for Apheresis guidelines.

  2012cited by this paper
• Point-of-Care Testing: A Prospective, Randomized Clinical Trial of Efficacy in Coagulopathic Cardiac Surgery Patients

  2012cited by this paper
• A Prospective, Randomized Clinical Trial of Efficacy in Coagulopathic Cardiac Surgery Patients

  2012cited by this paper
• Incompatible ABO-plasma exchange and its impact on patient selection in paediatric cardiac transplantation

  2012cited by this paper
• The Impact of Hematocrit on Fibrin Clot Formation Assessed by Rotational Thromboelastometry

  2012cited by this paper
• Plasma Exchange and Immunoadsorption of Patients with Thoracic Organ Transplantation

  2012cited by this paper
• Role of Plasma Exchange in the Thyroid Storm

  2011cited by this paper
• Theoretical efficacy of using albumin/plasma versus full plasma replacement in TTP

  2011cited by this paper
• Virus Removal and Eradication by Modified Double Filtration Plasmapheresis Decreases Factor XIII Levels

  2010cited by this paper
• Recovery of fibrinogen after administration of fibrinogen concentrate to patients with severe bleeding after cardiopulmonary bypass surgery

  2010cited by this paper
• Is preoperative fibrinogen predictive for postoperative bleeding after coronary artery bypass grafting surgery?

  2009cited by this paper
• Pharmacokinetics and safety of fibrinogen concentrate

  2009cited by this paper
• Comparing the prothrombin time INR versus the APTT to evaluate the coagulopathy of acute trauma.

  2007cited by this paper
• Management of patients with preformed reactive antibodies who are awaiting cardiac transplantation.

  2005cited by this paper
• Extracorporeal removal of antimicrobials during plasmapheresis

  2003cited by this paper
• Hormonal resuscitation yields more transplanted hearts, with improved early function1

  2003cited by this paper
• Incidence of allergic reactions with fresh frozen plasma or cryo‐supernatant plasma in the treatment of thrombotic thrombocytopenic purpura

  2001cited by this paper
• A Review of the Effects of Plasmapheresis on Drug Clearance

  1997cited by this paper
• Improved survival in thrombotic thrombocytopenic purpura-hemolytic uremic syndrome. Clinical experience in 108 patients.

  1991cited by this paper

• Usefulness of Global Coagulation Tests, Thrombin Generation and Viscoelastic Tests for Assessing the Bleeding Phenotype in Rare Coagulation Factor Deficiencies

  2025cites this paper
• Efficacy of Therapeutic Plasma Exchange or Cangrelor as an Adjunctive Strategy to Facilitate Cardiopulmonary Bypass in Patients with Heparin-Induced Thrombocytopenia: A Systematic Review and Meta-Analysis.

  2024cites this paper
• Mitigating the Prozone‐Like Effect in HLA Antibody Testing: A Case Report of Therapeutic Plasma Exchange for Antibody‐Mediated Rejection Post‐Heart Transplantation

  2024cites this paper
• A novel device and system concept for therapeutic plasma exchange in rats

  2023cites this paper
• Viscoelastic Haemostatic Assays in Cardiovascular Critical Care

  2020cites this paper
• Perioperative Applications of Therapeutic Plasma Exchange in Cardiac Surgery: A Narrative Review.

  2020cites this paper
• Literature review of apheresis procedures performed perioperatively in cardiac surgery for ASFA category indications

  2018cites this paper
• Perioperative management of rare coagulation factor deficiency states in cardiac surgery

  2017cites this paper