Jeff Winters described the essentials of therapeutic apheresis in the previous episode. He’s back to explain how to use those principles to treat Thrombotic Thrombocytopenic Purpura (TTP).

Jeff Winters

Dr. Jeff Winters

Most people who listen 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, no one can sit around and wait and think when a patient even “might” have TTP, since quick action can save a patient’s life! It is essential to understand the steps clinicians and Transfusion Medicine experts take get to that decision point.

Re-introducing the Expert!

Jeff Winters gave us a terrific overview of therapeutic apheresis 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.

About My Guest:

Dr. Jeff Winters is a graduate of the University of Kentucky College of Medicine. His postgraduate training included an Anatomic/Clinical Pathology residency at the University of Kentucky and a Transfusion Medicine/Blood Banking fellowship at the Mayo Clinic in Rochester, Minnesota. He is certified by the American Board of Pathology in Anatomic Pathology, Clinical Pathology, and Blood Banking/Transfusion Medicine.

Dr. Winters is a Professor of Laboratory Medicine and Pathology in the Mayo College of Medicine. He is the Program Director of the Mayo Clinic Transfusion Medicine/Blood Banking Fellowship Program, Vice-chair of the Division of Transfusion Medicine, and Medical Director of the Mayo Clinic Therapeutic Apheresis Treatment Unit.

Dr. Winters is actively involved in the American Society for Apheresis (ASFA) and previously served as the president of that organization. He is editor-in-chief of the Journal of Clinical Apheresis.

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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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