HEMOSTATIC IMBALANCE OF PLASMA-EXCHANGE TRANSFUSION

  • 1 January 1979
    • journal article
    • research article
    • Vol. 54  (3) , 694-702
Abstract
Plasma exchange was proposed as a treatment for multiple disorders. Three patients with amyotropic lateral sclerosis, who were hemostatically normal, were studied through 11 4 l exchanges. Plasma was replaced by an equal volume of 5% albumin or 5% plasma protein fraction. Serial studies revealed that immediately after the exchange transfusion, there was significant prolongation of the prothrombin, partial thromboplastin and thrombin times with reduction of the fibrinogen and antithrombin III levels. Factors V, VII-X, IX and X were all significantly decreased, as were the factor VII related antigen, procoagulants [factor VII C] and the ristocetin cofactor activities. Platelet counts were obtained before and after exchanges and revealed significant decreases. All parameters remained abnormal 4 h after exchanges except the factor IX, ristocetin cofactor and factor VII C activities. By 24 h, all hemostatic parameters had returned to normal. Plasma-exchange transfusion with material devoid of coagulation factors apparently resulted in a coagulation defect that may be of clinical significance in a hemostatically compromised patient.