Peripheral vascular access for therapeutic plasma exchange: A practical approach to increased utilization and selecting the most appropriate vascular access

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review


  • David Barth, University Health Network
  • ,
  • Amber Sanchez, University of California at San Diego
  • ,
  • Anna Marie Thomsen
  • ,
  • Alicia Garcia, USCF
  • ,
  • Roman Malachowski, Institute of Polish Mother's Health Center
  • ,
  • Rebecca Weldon, University of Pennsylvania
  • ,
  • Michaela Mayhew, St George's University Hospitals NHS Foundation Trust
  • ,
  • Kari Mudie, Royal Brisbane and Women's Hospital
  • ,
  • Dawn Faller, Terumo BCT
  • ,
  • Joseph Schwartz, Columbia University

Background: Therapeutic plasma exchange (TPE) is used in the treatment of many diseases. At present, peripheral vascular access (PVA) is an underutilized method of vascular access in TPE. It should be considered more frequently due its relatively low risk for adverse events, particularly infections. Methods: The Advancing Vascular Access in Apheresis Working Group met in December 2017 for an extensive review and discussion of vascular access for TPE and developed a “road map” providing detailed information regarding clinical situations in which PVA-based TPE would and would not be appropriate. Results: The road map is consistent with current recommendations that PVA should be used in combination with TPE whenever possible. PVA should be considered for patients who do not have existing central lines and who are stable. The patient should have peripheral veins that will allow for adequate treatment and must be able to comply with the process of achieving and maintaining peripheral access. There should be expert clinical assessment of veins, and this evaluation may include ultrasound and/or near infrared evaluation. Conditions that would prompt a switch from PVA to an alternate method of venous access include loss of venous access, patient preference, or development of a requirement for very frequent treatment over a long period of time. Conclusions: While PVA is not suitable for all patients requiring TPE, it has significant safety advantages over other approaches and should be employed whenever possible.

Original languageEnglish
JournalJournal of Clinical Apheresis
Pages (from-to)178-187
Publication statusPublished - Jun 2020

    Research areas

  • decision algorithm, peripheral venous access, therapeutic plasma exchange, vascular access

See relations at Aarhus University Citationformats

ID: 191299932