Perfil dos procedimentos de plasmaférese terapêutica realizados pelo hemocentro da UNICAMP

Abstract

Therapeutic plasmapheresis is a therapy used for several diseases in various medical specialties, which consists of the patient's plasma withdrawal and replacement with fresh frozen plasma or human albumin in continuous or discontinuous flow apheresis devices. Our objective was to establish the profile of therapeutic plasmapheresis procedures performed by the Bloodcenter of UNICAMP in Hospital de Clínicas of UNICAMP, by comparing to International Protocols and to analyze the congruence of the indications of the procedures through a retrospective survey of the data of the therapeutic plasmapheresis procedures performed. The procedures profile was established according to the last Society for Apheresis (ASFA) protocol published at 2016 for the indications criteria and technical parameters. In the observed period (between 2016 and 2017), 295 therapeutic plasmapheresis procedures were performed in 48 patients in the specialties of cardiology, hematology, nephrology and neurology. The diagnoses were desensitization pre cardiac transplantation, antibodymediated rejection post cardiac transplantation, thrombotic thrombocytopenic purpura (PTT), multiple myeloma (MM), Waldenström macroglobulinemia (MW), uremic hemolytic syndrome (SHU), focal segmental glomerulosclerosis (GESF), desensitization pre renal transplantation, myasthenia gravis (MG), optic neuromyelitis (NMO), Guillain-Barré syndrome (SGB) and stiff man syndrome (SHR). Regarding the indication criteria, the great majority of the procedures are in agreement with the recommendations of ASFA's protocol and as for the technical parameters, we have that the quantity and frequency of sessions and liquid of replacement used are congruent with the protocol, however, the volume used did not always follow the recommendations due to the difficulty in obtaining some information from the patient at the time of the procedures. The medical specialty of hematology had the largest number of procedures and the neurology had the greatest number of patients. The most frequent diagnosis was PTT in number of procedures and, GESF in number of patients.