Treatment

Desired Outcomes

The main goal of TTP treatment is to prevent end-organ damage. Nonpharmacologic Therapy

® The present standard of treatment for TTP is urgent plasma exchange (PEX). If PEX is unavailable, treatment with plasma infusion and glucocorticoids is indicated

until PEX is available. Plasma Exchange

The procedure involves removal of the patient's plasma and its substitution by donor plasma. In this manner, circulating antibody inhibitor of ADAMTS13 is removed and enzyme is replenished. PEX involves placement of two IV lines (cannulae) into two separate veins. Blood removed through one cannula is centrifuged to separate the blood cells from the plasma. The blood cells are mixed subsequently with donor plasma and returned to the patient via the second cannula. The goal is to exchange 1 to 1.5 plasma volumes (40-60 mL/kg). The procedure generally is repeated daily until neurologic symptoms resolve and normal LDH and platelet counts are maintained for several days. After complete remission is achieved, PEX frequency can be reduced to every other day for an additional few days, with subsequent PEX discontinuation and close patient follow-up. When PEX is started immediately upon diagnosis, remission and survival rates at six months are approximately 80%. Although generally considered safe, complications from catheter insertion or catheter infection may occur and include hemorrhage, pneumothorax, sepsis, and thrombosis. Allergic reactions to

plasma can cause severe hypotension and hypoxia.

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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