Jeff Winters

Dr. Jeff Winters

Dr. Jeff Winters from Mayo Clinic, Rochester, MN returns to discuss a true, honest-to-goodness blood bank treatment emergency, Thrombotic Thrombocytopenic Purpura (TTP).

Most people listening to this podcast are involved in blood banking in one way or another. In general, blood bankers like to do things in an organized, “take-your-time” fashion (it’s just our nature!). However, we can’t sit around and wait and think when we have a patient with TTP; we must act quickly! Since we must be prompt, we could really use a guide to get us to a decision point.

Jeff Winters practices therapeutic apheresis all day long, and he gave us a terrific overview in BBGuy Essentials 025. Today’s episode addresses how to use those principles to treat TTP. This terrifying disease, caused in adults primarily by a deficiency of an enzyme with a funny name, “ADAMTS13“, can be rapidly fatal if not promptly diagnosed and treated. In modern practice, treatment is primarily done using Therapeutic Plasma Exchange (TPE), with replacement of the “bad” plasma with “good.” Dr. Winters helps us understand the pathophysiology of this nasty disease, as well as when we should pull the trigger on treating patients suspected of having TTP. He will also discuss the use of the poorly understood blood product, “cryo-poor plasma,” as a replacement fluid option. Trainees and practitioners in pathology, hematology, and laboratory sciences will benefit from this discussion.

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DISCLAIMER: The opinions expressed on this episode are those of my guest and I alone, and do not reflect those of the organizations with which either of us is affiliated. Neither Dr. Winters nor I have any relevant financial disclosures.

The images below are generously provided by Dr. Winters.

Winters Slide 1 - Features of TTP
Winters Slide 2 - Mechanism of TTP
Winters Slide 3 - Why do plasma exchange in TTP?
Winters Slide 4 - TPE in TTP details
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