Abstract: SA-PO1113
Application of American Society for Apheresis (ASFA) Guideline Recommendations for Therapeutic Plasma Exchange (TPE): A Scoping Review of Published Literature
Session Information
- Kidney Replacement Therapy and Care Delivery Innovations
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Schmitt, Jana, Universiteit Maastricht Faculty of Health Medicine and Life Sciences, Maastricht, LI, Netherlands
- Klein, Sophie, Fresenius Medical Care Deutschland GmbH, Bad Homburg, HE, Germany
- Kotanko, Peter, Renal Research Institute, New York, New York, United States
- Pham, Ngoc, Fresenius Medical Care Deutschland GmbH, Bad Homburg, HE, Germany
- Derlet-Savoia, Anja, Fresenius Medical Care Deutschland GmbH, Bad Homburg, HE, Germany
- Kooman, Jeroen, Universiteit Maastricht Faculty of Health Medicine and Life Sciences, Maastricht, LI, Netherlands
- Stauss-Grabo, Manuela, Fresenius Medical Care Deutschland GmbH, Bad Homburg, HE, Germany
Background
Exchanged plasma volume (PV) is a central dosing parameter in therapeutic plasma exchange (TPE) and an important determinant of efficacy, risk, and resource utilization. Although the American Society for Apheresis (ASFA) provides evidence-based guidelines with indication-specific recommendations for exchange volume, it remains unclear whether per-treatment exchange volumes reported in the literature correspond to these targets across indications. Given the heterogeneous reporting in the published literature, we conducted a scoping review to assess whether reported per-treatment exchange volumes align with the target ranges specified in the 2023 ASFA Guidelines.
Methods
A scoping review was conducted in accordance with Joanna Briggs Institute (JBI) methodological guidance. An a priori protocol was registered at the Open Science Framework. Systematic searches were conducted in PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) between July and October 2025, limited to English and German. Primary studies in adults undergoing TPE for selected guideline-based and high-frequency indications were eligible if exchange volumes were reported. Studies were screened against prespecified criteria. Reported per-treatment exchange volumes were assessed using predefined analytical pathways.
Results
A total of 1,490 records were identified, and 201 studies were included. Among studies eligible for direct comparison with ASFA recommendations, 76.4% of unambiguously classifiable studies reported per-treatment exchange volumes within the recommended range. Reporting was heterogeneous in format and detail. Indication-specific patterns were observed, including lower-volume treatment approaches in a subset of Guillain–Barré syndrome studies, frequent exchange volumes below the guideline-recommended high-volume target range in acute liver failure, and a tendency toward higher exchange volumes and intensified scheduling in thrombotic thrombocytopenic purpura.
Conclusion
Overall, reported per-treatment exchange volumes in TPE were mostly within ASFA guideline-recommended target ranges. Future research should prioritize standardized reporting in guideline-aligned units and examine how indication-specific TPE treatment strategies, including intensified scheduling and low- or high-volume approaches, relate to clinical outcomes.