Anticoagulation with low‐molecular‐weight heparin (dalteparin) in plasmapheresis therapy: initial experience

Abstract

Our initial experiences with LMWH for anticoagulation in plasmapheresis indicate that a body weight adjusted dose of LMWH (dalteparin) is suitable for anticoagulation in plasmapheresis therapy. No complications were observed. The data are encouraging. Further investigations will show if and how the present anticoagulation regime could be further optimized.

Membrane therapeutic plasma exchange with and without heparin anticoagulation

“…We also wanted to recommend a dose of nordaparin that could be safely used for TPE, because there are currently no such recommendations. According to Schintzel and associates, 40% of the deltaparin dose during TPE is lost through the plasma filter; consequently, the dose has to be 1.4‐times the hemodialysis dose . However, our study did not confirm that observation because there was no difference in incidence of blood clotting in the extracorporeal blood circuit with higher doses of nordaparin.…”

“…The number of apheresis procedures performed each year worldwide with UH is not negligible; however, there are surprisingly few studies about its complications and outcomes. Reports about apheresis or TPE without the use of anticoagulation or with the use of LMWH are even scarcer . Our study is the first to describe treatment and compare complications of a large number of TPE procedures performed with UH, with LMWH, and without anticoagulation.…”

“…When necessary, TPE can be performed without an anticoagulant by periodically flushing the bloodlines and filter with ∼500 mL saline. However, there are only a few studies on the usage of LMWH or saline flushing in TPE, and there are no recommendations . In the present study, we retrospectively analyzed our database to evaluate the safety of different types of heparin anticoagulation in TPE.…”

The effect of immunoadsorption with the Immusorba TR‐350 column on coagulation compared to plasma exchange

“…Low molecular weight heparins play an important role in the treatment and prevention of thromboembolic diseases . They have also been used effectively as anticoagulants for PE procedures instead of unfractionated heparin or citrate . However, there have been no data addressing the management of patients under (long‐term) anticoagulation during courses of plasma therapy.…”

Effects of therapeutic plasma exchange on anticoagulants in patients receiving therapeutic anticoagulation: a systematic review

“…Due to their known effects on coagulation proteins, therapeutic anticoagulants increase bleeding risk . However, studies suggest that, depending on the pharmacokinetic profile and timing of administration relative to the TPE procedure, anticoagulants are removed by TPE . Therefore, the combined hemostatic impact of both TPE and systemic anticoagulation is unknown.…”