Faculty Collaboration Database

Retrospective analysis of outcomes in patients with acute hypertriglyceridemic pancreatitis treated without therapeutic plasma exchange. Transfusion 2021 Feb;61(2):537-545

Date

02/23/2021

Pubmed ID

33616967

DOI

10.1111/trf.16214

Scopus ID

2-s2.0-85097232728 (requires institutional sign-in at Scopus site)   11 Citations

Abstract

BACKGROUND: Therapeutic plasma exchange (TPE) is often used to decrease serum triglyceride levels in hypertriglyceridemic pancreatitis (HTGP), although there is a lack of high-quality data directly attributing improved clinical outcomes to TPE. There are currently no large studies evaluating the treatment of HTGP without TPE.

STUDY DESIGN AND METHODS: This study retrospectively analyzes clinical and laboratory outcomes of 115 encounters at Massachusetts General Hospital (MGH) wherein a HTGP patient was treated without TPE and compares these outcomes to those of HTGP patients in the literature treated with TPE.

RESULTS: After management without TPE, the median reduction in serum triglycerides was 48% (IQR 29%-63%) on day one and 74% (IQR 60%-84%) on day two in 115 episodes of acute HTGP. The reductions were comparable to those reported in several large published case series after a course of TPE (65.8% to 81% reduction). In 25 episodes among 24 patients, treatment included admission to an intensive care unit. There was no significant difference in mortality or rates of local complication, mechanical ventilation, or use of vasoactive medication or renal replacement therapy between this ICU subset and published cohorts (all P > .05).

CONCLUSIONS: HTGP patients who do not receive TPE do not experience inferior outcomes compared to patients in the literature treated with TPE. The added value of TPE in HTGP, if any exists, needs to be demonstrated in controlled trials.

Author List

Hutchison B, Collins J, Makar RS, Dzik W

Author

Bailey Hutchison MD Assistant Professor in the Pathology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Child, Preschool
Critical Care
Drug Therapy, Combination
Female
Heparin
Humans
Hypertriglyceridemia
Insulin
Length of Stay
Male
Middle Aged
Pancreatitis
Plasma Exchange
Renal Replacement Therapy
Respiration, Artificial
Retrospective Studies
Severity of Illness Index
Treatment Outcome
Triglycerides
Vasodilator Agents