BOF: Transfusion (Plasma Products)

Which ONE of the following is unlikely to be a side effect of therapeutic plasma exchange?

a) Dyspnoea

b) Hypotension

c) Perioral tingling

d) Petechial haemorrhage

e) Uricaria

Answer:

d) Petechial haemorrhage

Explanation:

Therapeutic plasma exchange commonly depletes clotting proteins, fibrinogen and platelets (but only by 10-15% and hence not sufficient to lead to haemorrhage), as well as depleting ionised calcium due to the citrate anticoagulant in the exchange circuit, which may lead to paraesthesias, and should be treated with intravenous calcium gluconate.

Exposure to plasma products may lead to allergic reactions and hence uritaria, hypotension or dyspnoea should be investigated and treated as potential transfusion reactions.

Reference:

Howell C, Douglas K, Cho G, et al.: Guideline on the clinical use of apheresis procedures for the treatment of patients and collection of cellular therapy products. Transfus Med 2015; 25:57–78