{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T17:46:34Z","timestamp":1772214394227,"version":"3.50.1"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,6,1]],"date-time":"2016-06-01T00:00:00Z","timestamp":1464739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006432","name":"Terumo BCT","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006432","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Thrombotic thrombocytopenic purpura (TTP) is a rare but serious disease caused by autoantibody\u2010mediated deficiency in von Willebrand factor (VWF) cleaving protease, ADAMTS\u201013. The primary acute treatment is therapeutic plasma exchange (TPE). However, some patients can develop allergic\/anaphylactic reactions to the replacement (i.e., donor) plasma over time. Two potential treatment strategies for patients with TTP who demonstrate severe allergic reactions to plasma used for exchange were examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two patients with TTP exacerbations who developed severe allergic reactions to donor plasma were identified. One patient's TPE was re\u2010initiated with Octaplas, a lot\u2010batched solvent and detergent treated, type\u2010specific, pooled donor plasma product. The other patient was exchanged with primarily albumin, followed by slow incremental exposures to donor plasma to mitigate exposures and allergic risks. Both patients were assessed for anaphylaxis. <jats:bold>Results:<\/jats:bold> Both treatment strategies were successful in preventing any further clinically significant allergic\/anaphylactic reactions and facilitated both patients\u2019 TTP remissions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Based on our experience with two similar patients with TTP exacerbations and history of anaphylactic reactions to plasma during TPE, we have identified two possible treatment protocols to achieve remission in this clinical dilemma. Substituting Octaplas for standard plasma or, alternatively, using albumin with slowly increasing amounts of standard plasma may help to mitigate the risk of further anaphylactic adverse events. J. Clin. Apheresis 32:158\u2013162, 2017. \u00a9 2016 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jca.21475","type":"journal-article","created":{"date-parts":[[2016,6,1]],"date-time":"2016-06-01T05:46:53Z","timestamp":1464760013000},"page":"158-162","source":"Crossref","is-referenced-by-count":11,"title":["Two approaches to the clinical dilemma of treating TTP with therapeutic plasma exchange in patients with a history of anaphylactic reactions to plasma"],"prefix":"10.1002","volume":"32","author":[{"given":"Davinder","family":"Sidhu","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine Yale University School of Medicine New Haven Connecticut 06510"},{"name":"Department of Pathology and Laboratory Medicine University of Calgary Calgary Alberta , T2N 1N4 Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward L.","family":"Snyder","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Yale University School of Medicine New Haven Connecticut 06510"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher A.","family":"Tormey","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Yale University School of Medicine New Haven Connecticut 06510"},{"name":"Pathology &amp; Laboratory Medicine Service VA Connecticut Healthcare System West Haven Connecticut 06516"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-med-061813-013241"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2003.08.018"},{"key":"e_1_2_6_4_1","first-page":"1029","article-title":"Mild to moderate reduction of a von Willebrand factor cleaving protease (ADAMTS\u201013) in pregnant women with HELLP microangiopathic syndrome","volume":"88","author":"Lattuada A","year":"2003","journal-title":"Haematologica"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-925477"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1309\/LM3NAABJJK1HNYFU"},{"key":"e_1_2_6_7_1","unstructured":"National Healthcare Safety Network Biovigilance Component Hemovigilance Component Module Surveillance Protocol.http:\/\/www.cdc.gov\/nhsn\/pdfs\/biovigilance\/bv-hv-protocol-current.pdf"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.1025"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.20143"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(12)80135-1"},{"key":"e_1_2_6_11_1","first-page":"S273","article-title":"Plasma exchange for TTP using albumin as a replacement fluid: a 13 year experience","volume":"32","author":"Stack G","year":"1993","journal-title":"Transfusion"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2014.07.006"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2012.03646.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.2006.00884.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21288"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.2007.00940.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1159\/000264996"}],"container-title":["Journal of Clinical Apheresis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjca.21475","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjca.21475","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.21475","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T16:57:33Z","timestamp":1695574653000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jca.21475"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,6]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2017,6]]}},"alternative-id":["10.1002\/jca.21475"],"URL":"https:\/\/doi.org\/10.1002\/jca.21475","archive":["Portico"],"relation":{},"ISSN":["0733-2459","1098-1101"],"issn-type":[{"value":"0733-2459","type":"print"},{"value":"1098-1101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,6]]}}}