Abstract
<title>Abstract</title> <p>Aim: Current pharmacological approaches (statins, fibrates, and omega-3 fatty acids) may be insufficient to reduce elevated triglyceride levels and improve clinical outcomes. This study aimed to evaluate the acute effect of therapeutic plasma exchange (TPE) on lipid profile and its clinical success in patients with treatment-resistant severe hypertriglyceridemia. Materials and Methods: This single-center retrospective cohort study included 28 patients with severe hypertriglyceridemia who underwent TPE at the Endocrinology Clinic of Malatya Turgut Özal University Training and Research Hospital between 2024 and 2026. Patients’ demographic data, comorbidities, indications for plasmapheresis, number of sessions, and complications observed during the procedure were retrospectively reviewed and recorded. The efficacy and safety of therapeutic plasma exchange were evaluated. Results: The mean age of the 28 patients included in the study was 46.07 ± 12.93 years, and 60.7% of the patients were male. The most common indication for plasmapheresis was resistance to conventional drug therapy (82.1%), followed by acute pancreatitis (14.3%) and pregnancy (3.6%). A single session of TPE was performed in 53.6% of the patients, whereas two sessions were performed in 46.4%. Evaluation of post-procedural outcomes revealed an 89.3% reduction in serum triglyceride (TG) levels and a 36.9% reduction in total cholesterol levels. Despite this lipid clearance, a significant increase in HDL cholesterol levels and a marked decrease in C-reactive protein (CRP) levels were observed (p = 0.001). When the effects of TPE on hemostatic and metabolic balance were examined, the procedure was found to have a favorable safety profile. In contrast to the substantial reduction in lipid levels, decreases in hemoglobin and calcium levels remained clinically minimal. None of the patients required red blood cell suspension replacement. In addition, no statistically significant changes were observed in hematocrit, albumin, platelet count, or coagulation parameters, including PT, INR, and fibrinogen, before and after the procedure (p > 0.05). During the procedure, only one patient (3.6%) developed a mild allergic reaction, while no complications were observed in the other patients. Conclusion: Therapeutic plasma exchange is a highly clinically effective method that rapidly and markedly reduces triglyceride and total cholesterol levels in patients with severe hypertriglyceridemia, thereby minimizing the risk of acute complications.</p>