Merkezimizin terapötik plazmaferez endikasyonlarının retrospektif olarak değerlendirilmesi
Küçük Resim Yok
Tarih
2019
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Terapötik plazma değişimi (TPD), hasta plazmasındaki patolojik maddelerin (otoantikorlar, alloantikorlar, immün kompleksler, lipoproteinler, kriyoglobulinler vb.) hasta plazması ile birlikte vücuttan uzaklaştırılarak yerine replasman sıvısı (allojenik donör plazma, kolloid, kristalloid) konulması işlemidir. Terapötik plazma değişimi, yüksek morbidite ve mortaliteye neden olabilen birçok hastalıkta ya hastalığın primer tedavisinde (esas tedavi) ya da hastalığın esas tedavisinde tamamlayıcı tedavi (yardımcı tedavi) yöntemi olarak uygulanmaktadır. Günümüzde TPD başta hematolojik, nörolojik ve nefrolojik hastalıklar olmak üzere farklı birçok klinikte (toksikoloji endokrinoloji vb.) değişik hastalıklara/nedenlere bağlı olarak giderek artan endikasyonlarda kullanılmaktadır. Materyal ve Metot: Çalışmaya terapötik aferez merkezimizde Mayıs 2017 ile Mayıs 2019 tarihleri arasında terapötik plazma değişimi yapılan erişkin hastalar alındı. Hasta bilgileri terapötik aferez merkezi ve hastanemizin otomasyon sistemindeki hasta kayıtlarının retrospektif olarak incelenmesi ile elde edildi. Bulgular: Merkezimiz tarafından 441 hastaya toplamda 1957 TPD işleminin yapıldığı tespit edildi. TPD işlemi yaptığımız hastaların 255'inde (%57.8) endikasyonları karaciğer hastalıklarının (akut karaciğer yetmezliği, kronik karaciğer yetmezliğinin akut alevlenmesi ve karaciğer tranplantasyonu sonrası rejeksiyon), 186'sında (%42.2) ise karaciğer dışı hastalıkların oluşturduğunu tespit ettik. Karaciğer dışı hastalıklar sebebiyle TPD yapılan 186 hastadan 69'una (%37.1) hematolojik, 38'ine (%20.4) nörolojik, 32'sine (%17.2) renal ve 47'sine (%25.3) diğer hastalıklar nedeni ile TPD yapıldığını saptadık. Sonuç: Hastanemiz bünyesinde bulunan Karaciğer Nakli Enstitümüzde çok sayıda karaciğer nakli yapılması nedeniyle TPD endikasyonlarının çoğunu karaciğer hastalıklarının oluşturduğunu tespit ettik. Bununla birlikte karaciğer hastalıkları hariç tutularak yapılan TPD endikasyonlarının değerlendirilmesi sonucunda, TPD işlemi yapılan hasta endikasyonları ve bu endikasyonların sıklıklarının hem ülkemizden hem de yurtdışından bildirilen çalışma sonuçlarının çoğu ile uyumlu olduğunu tespit ettik.
Introduction: Therapeutic plasma exchange (TPE) is the process of pathological substances (autoantibodies, alloantibodies, immune complexes, lipoproteins, cryoglobulins, etc.) being removed from one's body with the patient plasma and them being replaced with replacement fluid (allogenic donor plasma, colloid, crystalloid). Therapeutic plasma exchange is used either as a primary treatment (primary treatment) or as a complementary treatment (adjunct treatment) in many diseases that can cause high morbidity and mortality. Nowadays, TPE is used in many different clinics (toxicology, endocrinology, etc.), especially in the treatment of hematological, neurological and nephrological diseases, and for an increasing number of indications due to different diseases. Materials and Methods: Adult patients who underwent therapeutic plasma exchange between May 2017 and May 2019 in our therapeutic apheresis center were included in the study. Patient information was obtained by retrospectively examining the patient records in the therapeutic apheresis center and the automation system of our hospital. Results: It was determined that a total of 1957 TPE procedures were performed on 441 patients by our center. The indications were liver diseases (acute liver failure, acute exacerbation of chronic liver failure and rejection after liver transplantation) in 255 (57.8%) patients and non-liver diseases in 186 (42.2%) patients. Of 186 patients who underwent TPE due to non-liver diseases, 69 (37.1%) had hematologic, 38 (20.4%) had neurological, and 32 (17.2%) had renal diesease. 47 (25.3%) TPE were performed due to other diseases. Conclusion: Due to the large number of liver transplants performed in our Liver Transplantation Institute, most of the indications for TPE were liver diseases. However, as a result of the evaluation of TPE indications excluding liver diseases, we found that the indications and the frequency of these indications were consistent with most of the reported results from both Turkey and abroad.
Introduction: Therapeutic plasma exchange (TPE) is the process of pathological substances (autoantibodies, alloantibodies, immune complexes, lipoproteins, cryoglobulins, etc.) being removed from one's body with the patient plasma and them being replaced with replacement fluid (allogenic donor plasma, colloid, crystalloid). Therapeutic plasma exchange is used either as a primary treatment (primary treatment) or as a complementary treatment (adjunct treatment) in many diseases that can cause high morbidity and mortality. Nowadays, TPE is used in many different clinics (toxicology, endocrinology, etc.), especially in the treatment of hematological, neurological and nephrological diseases, and for an increasing number of indications due to different diseases. Materials and Methods: Adult patients who underwent therapeutic plasma exchange between May 2017 and May 2019 in our therapeutic apheresis center were included in the study. Patient information was obtained by retrospectively examining the patient records in the therapeutic apheresis center and the automation system of our hospital. Results: It was determined that a total of 1957 TPE procedures were performed on 441 patients by our center. The indications were liver diseases (acute liver failure, acute exacerbation of chronic liver failure and rejection after liver transplantation) in 255 (57.8%) patients and non-liver diseases in 186 (42.2%) patients. Of 186 patients who underwent TPE due to non-liver diseases, 69 (37.1%) had hematologic, 38 (20.4%) had neurological, and 32 (17.2%) had renal diesease. 47 (25.3%) TPE were performed due to other diseases. Conclusion: Due to the large number of liver transplants performed in our Liver Transplantation Institute, most of the indications for TPE were liver diseases. However, as a result of the evaluation of TPE indications excluding liver diseases, we found that the indications and the frequency of these indications were consistent with most of the reported results from both Turkey and abroad.
Açıklama
Anahtar Kelimeler
Hematoloji, Hematology
