Therapeutic Plasma Exchange in Thailand: A 10-Year Retrospective Analysis
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Issued Date
2026-01-01
Resource Type
ISSN
17449979
eISSN
17449987
Scopus ID
2-s2.0-105036366168
Journal Title
Therapeutic Apheresis and Dialysis
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SCOPUS
Bibliographic Citation
Therapeutic Apheresis and Dialysis (2026)
Suggested Citation
Vareesangthip K., Ounhasuttiyanon A., Pongsakornkullachart K., Rochaikun K., Jitprapaikulsan J., Siritho S., Permpikul P., Lumpaopong A., Vareesangthip K. Therapeutic Plasma Exchange in Thailand: A 10-Year Retrospective Analysis. Therapeutic Apheresis and Dialysis (2026). doi:10.1002/1744-9987.70148 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/116424
Title
Therapeutic Plasma Exchange in Thailand: A 10-Year Retrospective Analysis
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Abstract
Background: Therapeutic plasma exchange (TPE) is a cornerstone of therapeutic apheresis across multiple subspecialties. While international registries have described global practice, nationwide data from Thailand are lacking. Methods: We conducted a 10-year retrospective analysis of all TPE admissions reimbursed under Thailand's Universal Health Coverage scheme (2014–2023). Cases were identified using ICD-9 code 997.1. Demographics, clinical indications, complications, outcomes, and costs were extracted from discharge records. Indications were categorized according to the 2023 American Society for Apheresis (ASFA) guidelines. Results: A total of 5884 admissions were identified. The mean age was 46.4 ± 20.6 years, 58.0% were male, and 13.0% were pediatric. TPE Utilization increased from the mid-200s in 2014 to nearly 900 admissions in 2023. Neurological (28.9%) and nephrological (24.4%) disorders were the leading subspecialties. Systemic lupus erythematosus (12.4%), septic shock (12.1%), and acute inflammatory demyelinating polyradiculoneuropathy (9.1%) were the most frequent disease-specific indications. Nearly three-quarters of procedures were guideline-supported (Category I: 28.6%, Category II: 31.7%), while Category III use was 28.1% in our cohort. In-hospital mortality was 51.6% overall, driven largely by septic shock and acute liver failure, whereas survival exceeded 70% in autoimmune neurologic diseases and transplant recipients. Complications included bleeding (25.5%), transfusion requirements (69.0%), and hypocalcemia (9.7%). The actual cost per admission ranged USD 4000–12000, while reimbursement covered USD 2000–7000. Conclusion: This first nationwide analysis of TPE in Thailand highlights increasing utilization, high-cost burden, and important differences from global practice. Strengthening registries, refining coding systems, and developing region-specific guidelines will be critical to optimize outcomes and sustainability.