The management of anticoagulation in patients undergoing therapeutic plasma exchange: A concise review

On behalf of the Therapeutic Apheresis Subsection of the AABB

Research output: Contribution to journalReview article

8 Scopus citations


We surveyed multiple apheresis centers represented by the authors for their clinical approach to the management of anticoagulation issues during therapeutic plasma exchange (TPE). We present the results of their practices and a review of the pertinent literature. As plasma is removed during TPE, replacement with all or partial non-plasma-containing fluids (eg, 5% albumin) may lead to significant changes in hemostasis. These changes are amplified in patients who are receiving anticoagulation. We discuss various anticoagulants as well as the monitoring and adjustment of anticoagulation before, during, and after TPE. No single guideline can be applied, but rather, patients must be monitored individually, taking into account their often complex clinical conditions and medication profiles.

Original languageEnglish (US)
Pages (from-to)371-379
Number of pages9
JournalJournal of Clinical Apheresis
Issue number3
StatePublished - Jun 2018



  • direct oral anticoagulants
  • direct thrombin inhibitors
  • low molecular weight heparins
  • platelet inhibitors
  • unfractionated heparin

ASJC Scopus subject areas

  • Hematology

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