Facilities, selection, outcome measurement, and limitations of therapeutic plasma exchange for neuroimmunological disorders: The South East Asian survey study
Issued Date
2023-01-01
Resource Type
ISSN
07332459
eISSN
10981101
Scopus ID
2-s2.0-85150515045
Pubmed ID
36896493
Journal Title
Journal of Clinical Apheresis
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Clinical Apheresis (2023)
Suggested Citation
Rattanathamsakul N., Siritho S., Viswanathan S., Hiew F.L., Apiwattanakul M., Tan K., Thirugnanam U.N., Yeo T., Quek A.M.L., Estiasari R., Remli R., Aye S.M.M., Ohnmar O., Hoang N.T.T., Pasco P.M. Facilities, selection, outcome measurement, and limitations of therapeutic plasma exchange for neuroimmunological disorders: The South East Asian survey study. Journal of Clinical Apheresis (2023). doi:10.1002/jca.22047 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/82557
Title
Facilities, selection, outcome measurement, and limitations of therapeutic plasma exchange for neuroimmunological disorders: The South East Asian survey study
Author's Affiliation
Siriraj Hospital
National University Health System
Yangon General Hospital
Philippine General Hospital
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Kuala Lumpur Hospital
National Neuroscience Institute of Singapore
Bumrungrad International Hospital
Universiti Kebangsaan Malaysia
Aryu International Hospital
Neurological Institute of Thailand
Military Hospital 175
National University Health System
Yangon General Hospital
Philippine General Hospital
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Kuala Lumpur Hospital
National Neuroscience Institute of Singapore
Bumrungrad International Hospital
Universiti Kebangsaan Malaysia
Aryu International Hospital
Neurological Institute of Thailand
Military Hospital 175
Other Contributor(s)
Abstract
Introduction: Therapeutic plasma exchange (TPE) for neuroimmunological disorders has played an important role in the Southeast Asian region. This study investigates the challenges of performing TPE within the region. Method: A questionnaire-based survey was conducted and launched to 15 South East Asian Therapeutic Plasma Exchange Consortium (SEATPEC) members from seven countries in January 2021. It included demographics, TPE techniques, indications, challenges, timing, outcome measurement, and access to laboratory testing in each local center. Results: A total of 15 neurologists from 12 participating centers were included. They usually perform five sessions of TPE (100.0%), with 1 to 1.5 plasma volume (93.3%), and exchanges via the central catheter (100.0%). Acute relapses of neuromyelitis optica spectrum disorder and myasthenia gravis are the most common indications. They used a combination of normal saline and 5% albumin (60.0%) as replacement fluid. Most (66.7%) used TPE as an add-on treatment in steroid-refractory cases or as first-line treatment for severe attacks. They suggested assessing the TPE efficacy of TPE by the interval to the next attack, post-TPE relapse rates, and TPE-related complications. The major challenges within our region are expense, reimbursibility, and access to TPE. Conclusion: Although countrywise differences exist, all share similarities regarding methods, indications, timing, obstacles, and challenges of TPE for neuroimmunological conditions. Regional collaboration will be essential to identify strategies to reduce these barriers to access to TPE in the future.