{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T09:53:00Z","timestamp":1789638780707,"version":"4.0.0"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,2,14]],"date-time":"2019-02-14T00:00:00Z","timestamp":1550102400000},"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":["Transfusion"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:p>Therapeutic plasma exchange (TPE) removes coagulation proteins, but its impact on therapeutic anticoagulation is unknown. We performed a systematic review of the literature to determine the coagulation effects of TPE in patients receiving systemic anticoagulation. We searched MEDLINE, CINAHL, EMBASE, and Web of Science until June 2018 for studies combining controlled vocabulary and keywords related to therapeutic plasma exchange, plasmapheresis, anticoagulants, and therapy. The primary outcome was the effect of TPE on anti\u2010Xa activity, activated partial thromboplastin time (aPTT), or international normalized ratio (INR). The secondary outcome was reports of post\u2010TPE bleeding or thrombosis. A total of 1830 references were screened and eight studies identified. Our selected studies (five case reports and three case series) involved 23 patients and evaluated the effects of seven anticoagulants. Six studies of unfractionated heparin, low\u2010molecular\u2010weight heparins, and direct oral anticoagulants demonstrated an anti\u2010Xa level decline. Two studies of unfractionated heparin and low\u2010molecular\u2010weight heparins showed an aPTT increase. One study of warfarin showed a post\u2010TPE INR increase. Reports of post\u2010TPE bleeding occurred in two patients and thrombosis in one. In patients receiving therapeutic anticoagulation, TPE is associated with anti\u2010Xa activity decline and aPTT and INR increase. These coagulation changes do not appear to significantly increase bleeding or thrombotic risk. Our data suggest the need for prospective studies to investigate the true clinical impact of TPE on therapeutic anticoagulation.<\/jats:p>","DOI":"10.1111\/trf.15191","type":"journal-article","created":{"date-parts":[[2019,2,14]],"date-time":"2019-02-14T16:33:50Z","timestamp":1550162030000},"page":"1870-1879","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Effects of therapeutic plasma exchange on anticoagulants in patients receiving therapeutic anticoagulation: a systematic review"],"prefix":"10.1111","volume":"59","author":[{"given":"Kimberly L.","family":"Hodulik","sequence":"first","affiliation":[{"name":"Division of Hematology, Department of Medicine Duke University Medical Center  Durham North Carolina"},{"name":"Department of Pharmacy Duke University Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam G.","family":"Root","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Duke University Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila S.","family":"Ledbetter","sequence":"additional","affiliation":[{"name":"Duke University Medical Center Library Duke University Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7266-7101","authenticated-orcid":false,"given":"Oluwatoyosi A.","family":"Onwuemene","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Duke University Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.2920030209"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2014.08.018"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.20143"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0130402"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12347"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21257"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.2920090102"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1979.tb01172.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2014.10.006"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1989.29289146829.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.20059"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-10-120543"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-013-0899-7"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.14503\/THIJ-14-4424"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001721-200006000-00012"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2006.00755.x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21294"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1907"},{"key":"e_1_2_8_20_1","unstructured":"Covidence systematic review software. 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