{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T04:18:30Z","timestamp":1778645910936,"version":"3.51.4"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T00:00:00Z","timestamp":1678320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A questionnaire\u2010based 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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\u2010on treatment in steroid\u2010refractory cases or as first\u2010line treatment for severe attacks. They suggested assessing the TPE efficacy of TPE by the interval to the next attack, post\u2010TPE relapse rates, and TPE\u2010related complications. The major challenges within our region are expense, reimbursibility, and access to TPE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jca.22047","type":"journal-article","created":{"date-parts":[[2023,3,10]],"date-time":"2023-03-10T08:21:39Z","timestamp":1678436499000},"page":"437-446","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Facilities, selection, outcome measurement, and limitations of therapeutic plasma exchange for neuroimmunological disorders: The South East Asian survey study"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1698-0520","authenticated-orcid":false,"given":"Natthapon","family":"Rattanathamsakul","sequence":"first","affiliation":[{"name":"Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sasitorn","family":"Siritho","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand"},{"name":"Department of Neurology Bumrungrad International Hospital Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0094-0540","authenticated-orcid":false,"given":"Shanthi","family":"Viswanathan","sequence":"additional","affiliation":[{"name":"Department of Neurology Kuala Lumpur Hospital Kuala Lumpur Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4708-3734","authenticated-orcid":false,"given":"Fu Liong","family":"Hiew","sequence":"additional","affiliation":[{"name":"Department of Neurology Kuala Lumpur Hospital Kuala Lumpur Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Metha","family":"Apiwattanakul","sequence":"additional","affiliation":[{"name":"Department of Neurology Neurological Institute of Thailand Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Neurology National Neuroscience Institute Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umapathi N.","family":"Thirugnanam","sequence":"additional","affiliation":[{"name":"Department of Neurology National Neuroscience Institute Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tianrong","family":"Yeo","sequence":"additional","affiliation":[{"name":"Department of Neurology National Neuroscience Institute Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy M. L.","family":"Quek","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine National University Health System Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riwanti","family":"Estiasari","sequence":"additional","affiliation":[{"name":"Department of Neurology Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital Jakarta Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rabani","family":"Remli","sequence":"additional","affiliation":[{"name":"Department of Neurology National University of Malaysia Kuala Lumpur Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seinn Mya Mya","family":"Aye","sequence":"additional","affiliation":[{"name":"Department of Neurology Aryu International Hospital Yangon Myanmar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ohnmar","family":"Ohnmar","sequence":"additional","affiliation":[{"name":"Department of Neurology Yangon General Hospital Yangon Myanmar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0054-7212","authenticated-orcid":false,"given":"Nghia T. T.","family":"Hoang","sequence":"additional","affiliation":[{"name":"Department of Neurology Military Hospital 175 Ho Chi Minh City Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul M.","family":"Pasco","sequence":"additional","affiliation":[{"name":"Department of Neurosciences Philippine General Hospital Manila Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,3,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.12806"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21630"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21937"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00389"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12974-021-02319-4"},{"issue":"4","key":"e_1_2_10_7_1","first-page":"286","article-title":"Prevalence of factors associated with poor outcomes of hospitalized myasthenia gravis patients in Thailand","volume":"19","author":"Tiamkao S","year":"2014","journal-title":"Neurosciences (Riyadh)"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00501"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1586\/14737175.2016.1150178"},{"issue":"5","key":"e_1_2_10_10_1","first-page":"383","article-title":"Guillain\u2010Barr\u00e9 syndrome: rehabilitation outcome and recent developments","volume":"71","author":"Melillo EM","year":"1998","journal-title":"Yale J Biol Med"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2013.07.017"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21705"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318207b1f6"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jns.12455"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/11795735211057314"},{"issue":"4","key":"e_1_2_10_16_1","doi-asserted-by":"crossref","first-page":"389","DOI":"10.4103\/aian.AIAN_365_19","article-title":"Plasma exchange as a first line therapy in acute attacks of neuromyelitis optica spectrum disorders","volume":"22","author":"Kumawat BL","year":"2019","journal-title":"Ann Indian Acad Neurol"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2019.101506"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.1010"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2017-316286"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12629"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/practneurol-2019-002336"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000504"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.13456"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.58.1.143"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.04680513"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.3988\/jcn.2013.9.1.36"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.51203"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-10257-z"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjno-2019-000020"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.13548"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-022862"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21669"}],"container-title":["Journal of Clinical Apheresis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.22047","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jca.22047","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.22047","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T17:41:33Z","timestamp":1702057293000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jca.22047"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,9]]},"references-count":31,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1002\/jca.22047"],"URL":"https:\/\/doi.org\/10.1002\/jca.22047","archive":["Portico"],"relation":{},"ISSN":["0733-2459","1098-1101"],"issn-type":[{"value":"0733-2459","type":"print"},{"value":"1098-1101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,9]]},"assertion":[{"value":"2022-08-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}