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Adverse events in apheresis : an update of the WAA registry data

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Abstract
Apheresis with different procedures and devices are used for a variety of indications that may have different adverse events (AEs). The aim of this study was to clarify the extent and possible reasons of various side effects based on data from a multinational registry. The WAA-apheresis registry data focus on adverse events in a total of 50846 procedures in 7142 patients (42% women). AEs were graded as mild, moderate (need for medication), severe (interruption due to the AE) or death (due to AE). More AEs occurred during the first procedures versus subsequent (8.4 and 5.5%, respectively). AEs were mild in 2.4% (due to access 54%, device 7%, hypotension 15%, tingling 8%), moderate in 3% (tingling 58%, urticaria 15%, hypotension 10%, nausea 3%), and severe in 0.4% of procedures (syncope/hypotension 32%, urticaria 17%, chills/fever 8%, arrhythmia/ asystole 4.5%, nausea/vomiting 4%). Hypotension was most common if albumin was used as the replacement fluid, and urticaria when plasma was used. Arrhythmia occurred to similar extents when using plasma or albumin as replacement. In 64% of procedures with bronchospasm, plasma was part of the replacement fluid used. Severe AEs are rare. Although most reactions are mild and moderate, several side effects may be critical for the patient. We present side effects in relation to the procedures and suggest that safety is increased by regular vital sign measurements, cardiac monitoring and by having emergency equipment nearby.
Keywords
Albumin, Donor, Plasma, Adverse events, Apheresis, SPECIAL-ISSUE, THROMBOTIC THROMBOCYTOPENIC PURPURA, CLINICAL-APPLICATIONS, THERAPEUTIC PLASMA-EXCHANGE, ORAL CALCIUM-CARBONATE, PLATELETPHERESIS, AMERICAN SOCIETY, ITALIAN REGISTRY, REPLACEMENT FLUID, COMPLEMENT ACTIVATION

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Citation

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Chicago
Mörtzell Henriksson, M, E Newman, V Witt, K Derfler, G Leitner, Sunny Eloot, Annemieke Dhondt, et al. 2016. “Adverse Events in Apheresis : an Update of the WAA Registry Data.” Transfusion and Apheresis Science 54 (1): 2–15.
APA
Mörtzell Henriksson, M., Newman, E., Witt, V., Derfler, K., Leitner, G., Eloot, S., Dhondt, A., et al. (2016). Adverse events in apheresis : an update of the WAA registry data. TRANSFUSION AND APHERESIS SCIENCE, 54(1), 2–15.
Vancouver
1.
Mörtzell Henriksson M, Newman E, Witt V, Derfler K, Leitner G, Eloot S, et al. Adverse events in apheresis : an update of the WAA registry data. TRANSFUSION AND APHERESIS SCIENCE. 2016;54(1):2–15.
MLA
Mörtzell Henriksson, M, E Newman, V Witt, et al. “Adverse Events in Apheresis : an Update of the WAA Registry Data.” TRANSFUSION AND APHERESIS SCIENCE 54.1 (2016): 2–15. Print.
@article{7184231,
  abstract     = {Apheresis with different procedures and devices are used for a variety of indications that may have different adverse events (AEs). The aim of this study was to clarify the extent and possible reasons of various side effects based on data from a multinational registry. 
The WAA-apheresis registry data focus on adverse events in a total of 50846 procedures in 7142 patients (42\% women). AEs were graded as mild, moderate (need for medication), severe (interruption due to the AE) or death (due to AE). 
More AEs occurred during the first procedures versus subsequent (8.4 and 5.5\%, respectively). AEs were mild in 2.4\% (due to access 54\%, device 7\%, hypotension 15\%, tingling 8\%), moderate in 3\% (tingling 58\%, urticaria 15\%, hypotension 10\%, nausea 3\%), and severe in 0.4\% of procedures (syncope/hypotension 32\%, urticaria 17\%, chills/fever 8\%, arrhythmia/ asystole 4.5\%, nausea/vomiting 4\%). 
Hypotension was most common if albumin was used as the replacement fluid, and urticaria when plasma was used. Arrhythmia occurred to similar extents when using plasma or albumin as replacement. In 64\% of procedures with bronchospasm, plasma was part of the replacement fluid used. 
Severe AEs are rare. Although most reactions are mild and moderate, several side effects may be critical for the patient. We present side effects in relation to the procedures and suggest that safety is increased by regular vital sign measurements, cardiac monitoring and by having emergency equipment nearby.},
  author       = {M{\"o}rtzell Henriksson, M and Newman, E and Witt, V and Derfler, K and Leitner, G and Eloot, Sunny and Dhondt, Annemieke and Deeren, D and Rock, G and Ptak, J and Blaha, M and Lanska, M and Gasova, Z and Hrdlickova, R and Ramlow, W and Prophet, H and Liumbruno, G and Mori, E and Griskevicius, A and Audzijoniene, J and Vrielink, H and Rombout, S and Aandahl, A and Sikole, A and Tomaz, J and Lalic, K and Mazic, S and Strineholm, V and Brink, B and Berlin, G and Dykes, J and Toss, F and Axelsson, CG and Stegmayr, B and Nilsson, T and Norda, R and Knutson, F and Ramsauer, B and Wahlstr{\"o}m, A},
  issn         = {1473-0502},
  journal      = {TRANSFUSION AND APHERESIS SCIENCE},
  keyword      = {Albumin,Donor,Plasma,Adverse events,Apheresis,SPECIAL-ISSUE,THROMBOTIC THROMBOCYTOPENIC PURPURA,CLINICAL-APPLICATIONS,THERAPEUTIC PLASMA-EXCHANGE,ORAL CALCIUM-CARBONATE,PLATELETPHERESIS,AMERICAN SOCIETY,ITALIAN REGISTRY,REPLACEMENT FLUID,COMPLEMENT ACTIVATION},
  language     = {eng},
  number       = {1},
  pages        = {2--15},
  title        = {Adverse events in apheresis : an update of the WAA registry data},
  url          = {http://dx.doi.org/10.1016/j.transci.2016.01.003},
  volume       = {54},
  year         = {2016},
}

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