Risk factors for hypotension and technical complications during single-session double-filtration plasmapheresis: a 15-year retrospective study of 1,022 procedures

< 0.05 for trend). Immune thrombotic thrombocytopenic purpura was independently associated with hypotension (OR 11.96, 95% CI 1.94-73.68). Older age modestly increased risk (OR 1.03 per year, 95% CI 1.00-1.06), while treatment year was inversely associated with hypotension (OR 0.77 per year, 95% CI 0.66-0.89). Technical complications were independently associated with use of the PLASAUTO Σ system (OR 8.78, 95% CI 2.76-27.97), use of non-heparin/non-nafamostat anticoagulants (OR 9.42, 95% CI 2.71-32.72), and hyperviscosity syndrome (OR 8.09, 95% CI 1.80-36.29). Among 309 sessions with paired measurements, median immunoglobulin reduction was 29.8% for IgG overall. DFPP demonstrated an acceptable safety profile, with declining complication rates over time. The risk of complications was influenced by underlying disease, patients' status, and anticoagulation strategy.