Universität zu Köln

von Heymann, Christian ORCID: 0000-0002-8162-8451, Lier, Heiko ORCID: 0000-0001-7374-4324, Rosenthal, Christoph and Kaufner, Lutz (2023). Indications for the Use of Therapeutic Plasma in Adult Patients. Transfus. Med. Hemother., 50 (2). S. 107 - 116. BASEL: KARGER. ISSN 1660-3818

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Abstract

Background: Different preparations for therapeutic plasma are available on the market. The German hemotherapy guideline has been completely updated in 2020 and, for this purpose, has reviewed the evidence for the most frequent clinical indications for the use of therapeutic plasma in adult patients. Summary: The German hemotherapy guideline has reviewed the evidence for the following indications for the use of therapeutic plasma in the adult patient: massive transfusion and bleeding, severe chronic liver disease, disseminated intravascular coagulation, plasma exchange for TTP, and the rare hereditary FV and FXI deficiencies. The updated recommendations for each indication are discussed on the background of existing guidelines and new evidence. For most indications, the quality of evidence is low due to missing prospective randomized trials or rare diseases. However, due to the balanced content of coagulation factors and inhibitors therapeutic plasma remains an important pharmacological treatment option in clinical situations with an already activated coagulation system. Unfortunately, the physiological content of coagulation factors and inhibitors limits the efficacy in clinical scenarios with high blood losses. Key Messages: The evidence for the use of therapeutic plasma for the replacement of coagulation factors due to massive bleeding is poor. Coagulation factor concentrates seem to be more appropriate for this indication, although the quality of evidence is also low. However, for diseases with an activated coagulation or endothelial system (e.g., disseminated intravascular coagulation, TTP) the balanced replacement of coagulation factors, inhibitors, and proteases may be of advantage.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code von Heymann, Christian UNSPECIFIED orcid.org/0000-0002-8162-8451 UNSPECIFIED Lier, Heiko UNSPECIFIED orcid.org/0000-0001-7374-4324 UNSPECIFIED Rosenthal, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaufner, Lutz UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-684724
DOI:	10.1159/000528136
Journal or Publication Title:	Transfus. Med. Hemother.
Volume:	50
Number:	2
Page Range:	S. 107 - 116
Date:	2023
Publisher:	KARGER
Place of Publication:	BASEL
ISSN:	1660-3818
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language FRESH-FROZEN PLASMA; FACTOR-V; THROMBIN GENERATION; SINGLE-CENTER; BLOOD-LOSS; FACTOR-VII; COAGULOPATHY; MANAGEMENT; TRANSFUSION; GUIDELINES Multiple languages Hematology; Immunology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/68472