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Therapeutic Plasma Exchange in Children - Experience From a Tertiary Care Center

Rufaida Mazahir1, Kanav Anand2, P K Pruthi2

  • 1Division of Pediatric Nephrology, Department of Pediatrics, Institute of Child Health, Sir Ganga Ram Hospital, New Delhi. Correspondence to: Dr Rufaida Mazahir, Division of Pediatric Nephrology, Department of Pediatrics, Institute of Child Health, Sir Ganga Ram Hospital, Old Rajender Nagar, New Delhi 110 060. rufaidamazahir@gmail.com.

Indian Pediatrics
|June 29, 2021
PubMed

Insights

Therapeutic plasma exchange (TPE) is safe and effective in children for various conditions, including renal and neurological diseases. Most pediatric patients showed significant recovery with minimal complications during TPE procedures.

Area of Science:

  • Pediatric Nephrology
  • Pediatric Neurology
  • Apheresis Medicine

Background:

  • Therapeutic plasma exchange (TPE) is a critical extracorporeal treatment for various pediatric conditions.
  • Assessing TPE's safety and efficacy in pediatric populations is essential for guiding clinical practice.
  • Limited data exists on TPE outcomes specifically in children across diverse indications.

Purpose of the Study:

  • To evaluate the safety, efficacy, and clinical outcomes of therapeutic plasma exchange (TPE) in pediatric patients.
  • To identify common indications and patient demographics undergoing TPE in a pediatric setting.
  • To analyze the types and frequency of complications associated with TPE in children.

Main Methods:

  • Retrospective analysis of hospital records for pediatric patients (<=18 years) who underwent TPE.
  • Data collection spanned from August 2011 to July 2018.
  • TPE was performed using membrane plasma separation, with specific replacement fluids noted for different indications.

Main Results:

  • 46 children underwent 293 TPE sessions; renal diseases (52.2%) and neurological illnesses (36.9%) were primary indications.
  • Atypical hemolytic uremic syndrome (aHUS) was the most frequent diagnosis (34.8%).
  • 86.9% of patients achieved complete or partial recovery, with minor complications like blood pressure fluctuations occurring in 7.1% of sessions.

Conclusions:

  • Therapeutic plasma exchange (TPE) is a safe and effective treatment modality for pediatric patients with both renal and non-renal conditions.
  • TPE demonstrates positive outcomes even in younger children, supporting its use across a wide pediatric age range.
  • The study reinforces the utility of TPE in managing severe pediatric diseases, with a favorable safety profile.
Abstract

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