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Therapeutic plasma exchange for life-threatening pediatric disorders

Jean-Sebastien Diana1,2, Sandra Manceau1,2, Tioka Rabeony3

  • 1Hôpital Necker Enfants Malades, Paris, France.

Journal of Clinical Apheresis
|September 1, 2021
PubMed

Insights

Therapeutic plasma exchange (TPE) is a viable treatment for critically ill children, with most adverse events being mild and unrelated to treatment specifics. This study confirms TPE

Area of Science:

  • Pediatric Nephrology
  • Pediatric Hematology
  • Critical Care Medicine

Background:

  • Therapeutic plasma exchange (TPE) is recognized for treating severe pediatric disorders.
  • Research on apheresis in pediatric populations is limited, with few studies featuring adequate patient numbers or control groups.
  • This study aimed to assess the safety and tolerance of TPE in pediatric patients.

Purpose of the Study:

  • To evaluate the tolerance and safety of therapeutic plasma exchange (TPE) in a pediatric cohort.
  • To identify potential risk factors associated with adverse events during TPE in children.
  • To contribute to the limited body of evidence on pediatric apheresis.

Main Methods:

  • Retrospective cohort study analyzing data from pediatric patients who underwent TPE between January 2005 and December 2014.
  • Data collected via a web-based electronic case report form.
  • Analysis included patient demographics, TPE indications, procedure details, and adverse events.

Main Results:

  • 78 pediatric patients underwent 731 TPE procedures for various conditions, including antibody-mediated rejection, thrombotic microangiopathy, and inflammatory diseases.
  • The majority of patients (92%) experienced adverse events (AEs), but most were mild and not linked to specific treatment parameters.
  • No deaths were attributed to the TPE procedure itself.

Conclusions:

  • This study represents one of the largest retrospective analyses of TPE in children to date.
  • TPE is feasible and can be safely administered to pediatric patients with life-threatening and refractory conditions.
  • The findings support the use of TPE in specialized pediatric care settings.
Abstract

Keywords:
adverse eventeCRF databasepediatric intensive care unit

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