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Therapeutic Plasma Exchange in Pediatric Patients: Results from a Single Center

Tahir Dalkiran1, Mehmet Mercan2, Sevcan Ipek3

  • 1Department of Pediatric Intensive Care, Necip Fazil City Hospital, Kahramanmaras, Türkiye.

Journal of Pediatric Intensive Care
|December 4, 2024
PubMed

Insights

Therapeutic plasma exchange (TPE) is effective for pediatric patients with various conditions. This study reviewed 128 TPE sessions in 25 children, highlighting its use in hematological, neurological, and autoimmune disorders.

Area of Science:

  • Pediatric Hematology
  • Pediatric Neurology
  • Pediatric Nephrology
  • Pediatric Rheumatology
  • Critical Care Medicine

Background:

  • Therapeutic plasma exchange (TPE) is an established treatment for several pediatric conditions.
  • Its application spans hematological, neurological, nephrological, and autoimmune/rheumatic disorders.
  • Experience and updated guidelines are crucial for optimizing TPE in pediatric care.

Purpose of the Study:

  • To report the institutional experience with Therapeutic Plasma Exchange (TPE) in pediatric patients.
  • To analyze the indications and outcomes of TPE sessions in a pediatric cohort.
  • To suggest updates to existing apheresis criteria based on emerging clinical conditions.

Main Methods:

  • Retrospective review of pediatric patient records.
  • Analysis of data from patients who underwent TPE between 2019 and 2021.
  • Inclusion of patient demographics, TPE indications, and session counts.

Main Results:

  • A total of 128 TPE sessions were performed in 25 pediatric patients (mean age 59.6 months).
  • Indications included sepsis with/without MODS, acute liver failure, hemolytic uremic syndrome (HUS), autoimmune hemolytic anemia, multiple sclerosis, autoimmune encephalitis, and MIS-C.
  • Specific cases involved myasthenia gravis crisis, meningococcemia, COVID-19-related HUS, HLH, and metabolic disorders.

Conclusions:

  • Therapeutic plasma exchange is a viable treatment option for a wide spectrum of pediatric diseases.
  • Current guidelines may need revision to encompass newly recognized conditions like MIS-C.
  • Further research is warranted to refine TPE protocols for pediatric populations.

Keywords:
American Society for Apheresis guidelinesmultisystem inflammatory syndrome in childrentherapeutic plasma exchange

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