20.500.12556/DiRROS-24488 A pilot study on the replacement of fibrinogen with fibrinogen concentrates during therapeutic plasma exchange with mild to moderate bleeding risk a comparison with fresh frozen plasma and albumin replacement Background: Therapeutic plasma exchange (TPE) removes coagulation factors and leads to depletion coagulopathy. The aim of the study was to compare hemostasis between TPE procedures without coagulation factor replacement (electrolyte group), the partial replacement of fibrinogen with fibrinogen concentrates (fibrinogen group) and partial coagulation factors replacement with fresh frozen plasma (partial FFP group). Methods: A total of 73 TPE procedures in patients with fibrinogen levels 1–2 g/L were divided into three study groups depending on clinically estimated bleeding risk. Standard coagulation and ROTEM® tests were performed before and after TPE. Results: Fibrinogen levels before TPE (p = 0.88) and after TPE (p = 0.33) were comparable between the fibrinogen and partial FFP groups. INR and ROTEM® parameters reflected moderately worse hemostasis after TPE with fibrinogen-only replacement compared to partial FFP replacement, which could result in increased bleeding risk. In the electrolyte group, most laboratory tests confirmed the most deranged hemostasis after TPE, as compared to fibrinogen or partial FFP replacement. A mild allergic reaction to FFP infusion was noted during one TPE. No clinically significant bleeding occurred in any of the study groups. Conclusions: Fibrinogen concentrate supplementation and partial FFP replacement can both maintain fibrinogen levels > 1 g/L after TPE, but modest differences in classical coagulation tests and bedside ROTEM® tests favor FFP replacement (NCT03801135). therapeutic plasma exchange coagulation fibrinogen concentrate fresh frozen plasma bleeding risk true false true Angleški jezik Ni določen Neznano 2025-12-01 15:02:33 2025-12-01 15:02:34 2025-12-02 03:42:05 0000-00-00 00:00:00 2024 0 0 Nasl. z nasl. zaslona; Opis vira z dne 24. 3. 2025; str. 1-11 iss. 24, ǂ[article no.] ǂ7662 Vol. 13 2024 0000-00-00 Zaloznikova Objavljeno apc 0000-00-00 0000-00-00 0000-00-00 616.6 2077-0383 10.3390/jcm13247662 230036995 RAZ_Zrimsek_Matej_2024.pdf RAZ_Zrimsek_Matej_2024.pdf 1 E59109F025E0AD1BB1887944DDA0EF90 c5acd2027c7424ebbbaca4d4975844900009d023b51a7143f22721ca1e0d4460 869e7491-cebe-11f0-94a7-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=36493 https://www.mdpi.com/2077-0383/13/24/7662 0 63ce73ce-cebe-11f0-94a7-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=36492 Univerzitetni klinični center Ljubljana 0 0 0