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Caitlin Raymond: Anticoagulation and TPE: More Nuanced Than You Think!
Caitlin Raymond/LinkedIn
Sep 25, 2025, 10:45

Caitlin Raymond: Anticoagulation and TPE: More Nuanced Than You Think!

Caitlin Raymond, a board-certified Clinical Pathologist and current Transfusion Medicine Fellow at the National Institutes of Health, shared on LinkedIn:

”Anticoagulation and TPE: More Nuanced Than You Think

When you see “anticoagulated patient” and “therapeutic plasma exchange (TPE)” in the same sentence, the reflex is clear: they’re going to bleed.

But that’s not always the case.

Over the last few years on service, I’ve learned that the reality is more complicated — and more interesting.

TPE doesn’t interact with all anticoagulants in the same way.

Some are cleared, some aren’t.

Some look scary on paper (hello, post-exchange INR bumps) but don’t consistently translate into bleeding at the bedside.

And antiplatelet agents? Not irrelevant — but not the whole story either.

In this new piece, I walk through:

  • Which anticoagulants are actually removed by TPE
  • When (and how) to adjust dosing
  • How citrate anticoagulation fits into the picture
  • What the reversal options look like
  • Why short courses are usually safe — and when bleeding risk does rise

The key takeaway: “anticoagulated” doesn’t automatically mean “unsafe.”

The art is knowing which drug, how often, and what else is going on with the patient.

If you’re running TPE, or just want a refresher on how meds and machines collide, I’d love for you to give it a read.”

Read the full post here.

Caitlin Raymond: Anticoagulation and TPE: More Nuanced Than You Think!

Find more on coagulation disorders featured in Hemostasis Today.

Anticoagulation apheresis Caitlin Raymond Health Hematology Hemostasis Hemostasis Today Medicine Therapeutic Plasma Exchange thrombosis TPE Transfusion Medicine
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