{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T22:45:07Z","timestamp":1788993907298,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T00:00:00Z","timestamp":1715212800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Plasma exchange (PLEX) therapy is indicated for several disorders. The 5% albumin is often used as a sole replacement fluid during most PLEX. However, each 1.0 plasma volume exchange depletes coagulation factors by ~65%. Although most coagulation factors recover to hemostatic levels within 24\u2009h post\u2010PLEX, fibrinogen requires 48\u201372\u2009h to recover. Fibrinogen is the key coagulation protein for hemostasis. Therefore, fibrinogen is often monitored during the acute course of PLEX, and plasma is supplemented to prevent bleeding if fibrinogen is &lt;100\u2009mg\/dL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design and Methods<\/jats:title>\n                    <jats:p>We conducted a prospective, single\u2010center, observational study to evaluate bleeding risk in adults who received an acute course of PLEX with a fibrinogen level of 80\u2013100\u2009mg\/dL without plasma supplementation during the procedure or before central venous catheter removal. The study group was compared to patients with plasma fibrinogen &gt;100\u2009mg\/dL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 275 patients who received 1406 PLEXes, 62 patients (23%) who underwent 323 PLEXes met the inclusion criteria, and only 2 (3%) patients had bleeding while on oral anticoagulants. In contrast, out of 275 patients, 143 (52%) with fibrinogen levels &gt;100\u2009mg\/dL received 751 PLEX treatments, and bleeding occurred in 2 (1%) while on low\u2010molecular\u2010weight heparin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggest that a pre\u2010procedure fibrinogen threshold of 80\u2013100\u2009mg\/dL without plasma supplementation does not increase bleeding risk unless patients were on anticoagulation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.17865","type":"journal-article","created":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T06:18:11Z","timestamp":1715235491000},"page":"1076-1082","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["A lower fibrinogen threshold does not lead to increased bleeding risk in patients receiving therapeutic plasma exchange: A prospective single\u2010center analysis"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3369-3573","authenticated-orcid":false,"given":"Amelework","family":"Wodajo","sequence":"first","affiliation":[{"name":"Department of Pathology UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi","family":"Sarode","sequence":"additional","affiliation":[{"name":"Department of Pathology UT Southwestern Medical Center  Dallas Texas USA"},{"name":"Department of Internal Medicine (Hematology\/Oncology)  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiney","family":"Valiyaparambil","sequence":"additional","affiliation":[{"name":"Department of Pathology UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2907-9993","authenticated-orcid":false,"given":"Christopher","family":"Webb","sequence":"additional","affiliation":[{"name":"Department of Pathology UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"De Simone","sequence":"additional","affiliation":[{"name":"Department of Pathology UT Southwestern Medical Center  Dallas Texas USA"},{"name":"Carter BloodCare  Bedford Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dill","family":"Rebecca","sequence":"additional","affiliation":[{"name":"Department of Pathology UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3170-6482","authenticated-orcid":false,"given":"Amena","family":"Usmani","sequence":"additional","affiliation":[{"name":"Department of Pathology UT Southwestern Medical Center  Dallas Texas USA"},{"name":"Department of Pathology University of California San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,9]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"Ec35","article-title":"Therapeutic plasma exchange\u2013an emerging treatment modality in patients with neurologic and non\u2010neurologic diseases","volume":"11","author":"Bobati SS","year":"2017","journal-title":"J Clin Diagn 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