Plasma exchange therapy in HELLP syndrome: a single-center experience.

BACKGROUND/AIMS The aim of this study was to investigate the effectiveness of plasma exchange therapy in patients with various forms of hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome. METHODS During a three-year period, 13 patients with HELLP syndrome were treated with one or two sessions of plasma exchange after delivery. Diagnosis of hemolysis, elevated liver enzymes, and low platelets syndrome was made according to Sibai's criteria, and the severity of illness was categorized according to platelet counts. Among patients, nine were in class-1 and the remaining four were in class-2. Patients with very high levels of aspartate aminotransferase (AST) (>2000 U/L) and lactate dehydrogenase (LDH) (>3000 U/L) were defined as fulminant type (2 cases). RESULTS Rapid improvement in platelet counts was observed after treatment with plasma exchange. All patients survived except the two fulminant hemolysis, elevated liver enzymes, and low platelets syndrome cases. CONCLUSION In our study, plasma exchange therapy was effective in patients with severe hemolysis, elevated liver enzymes, and low platelets syndrome, but fulminant cases did not appear to respond to this therapy.