The best therapy for a patient with thrombotic thrombocytopenic purpura is which of the following:

a. Plasmapheresis

Thrombotic thrombocytopenic purpura (TPP) is a relatively rare syndrome with no definitive diagnostic test or clinical characteristic. The principal clinical features are thrombocytopenic purpura, fever, microangiopathic hemolytic anemia, mental status changes, and renal dysfunction. Treatment is generally focused on the removal of the plasma constituents that lead to platelet aggregation. Plasmapheresis is particularly effective and has decreased the 1-year mortality rate of 50% to 80% to about 10%. Splenectomy was initially proposed for TPP but has been shown to have little benefit and instead is associated with a considerable risk of postsplenectomy sepsis. Corticosteroids and intravenous immune globulin are appropriate therapies for immune thrombocytopenic purpura (ITP), but not TPP.