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Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in critically...
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Reliable and High Efficiency Extraction of Kidney Immune Cells
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Seraph 100 Microbind Affinity Blood Filter for Persistent Pediatric BK Virus Nephropathy.

Meredith Harris1,2, Mahima Keswani1,2, Theresa Mottes1,2

  • 1Ann & Robert Lurie Childrens Hospital of Chicago, Chicago, Illinois, USA.

Pediatric Transplantation
|February 28, 2025
PubMed
Summary

The Seraph 100 filter successfully cleared BK viremia in a kidney transplant candidate, demonstrating a potential new therapy for BK viral infections, especially in patients with end-stage kidney disease.

Keywords:
end‐stage renal diseaseheart transplantimmunoadsorpsionkidney transplantationviral infection

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Area of Science:

  • Nephrology
  • Virology
  • Transplantation Immunology

Background:

  • BK viremia is a significant barrier to kidney transplantation, with limited effective therapies.
  • Current management often involves immunosuppression reduction, which can be insufficient.
  • The Seraph 100 filter utilizes heparin sulfate proteoglycans to bind pathogens, mimicking natural glycocalyx function.

Observation:

  • A 14-year-old patient with a history of cardiac transplant developed BK nephropathy and end-stage kidney disease (ESKD).
  • Despite 4 years of medical management and immunosuppression reduction, BK viral replication persisted.
  • The Seraph 100 Microbind Affinity Blood Filter was used extracorporeally with continuous renal replacement therapy (CRRT) for 48 hours.

Findings:

  • BK viral titers, after an initial slight increase, cleared within two months post-treatment.
  • The patient successfully underwent kidney transplantation without BK viremia recurrence.
  • No adverse events were noted, apart from transient emesis at CRRT initiation.

Implications:

  • This case presents proof of concept for the Seraph 100 filter's efficacy in clearing BK viremia.
  • The Seraph 100 may offer a viable therapeutic option for ESKD patients with existing dialysis access.
  • Further studies are warranted to explore the Seraph 100 as a treatment for BK viral infections.