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Plasma therapy for thrombotic thrombocytopenic purpura. Sometimes it works, but why?

Thrombotic thrombocytopenic purpura is characterized by thrombocytopenia, microangiopathic hemolytic anemia, and fluctuating, often bizarre, neurologic abnormalities. Fever and renal failure are also prominent in some patients. The classic histologic lesions, which appear to cause most of the symptoms, are microthrombi consisting mainly of platelets, which can be found in the capillaries of almost any tissue. Before 1965, thrombotic thrombocytopenic purpura was thought to be almost universally fatal. Subsequently, increasing numbers of patients treated with various combinations of corticosteroids, splenectomy, platelet inhibitors, and other agents were reported to have survived, but no consensus emerged with respect to the most effective regimen. . . .