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Key technical aspects and vascular access safety in membrane-based therapeutic plasma exchange for the pediatric

Magdalena Błasiak1,2, Przemysław Korohoda3, Katarzyna Zachwieja1,4

  • 1Department of Pediatric Nephrology and Hypertension, University Children's Hospital, Krakow, Poland.

Archives of Medical Science : AMS
|August 1, 2026
PubMed

Insights

Therapeutic plasma exchange (TPE) in children is complex. Prolonged catheter use increases technical issues, while FFP supplementation raises clinical risks. Older children face fewer clinical complications, highlighting age-specific safety needs.

Area of Science:

  • Pediatric Nephrology
  • Extracorporeal Therapies
  • Patient Safety

Background:

  • Therapeutic plasma exchange (TPE) is a critical blood purification technique.
  • Pediatric TPE presents unique technical challenges and heightened risks compared to adults.
  • Assessing safety in pediatric TPE is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To evaluate the safety of vascular access and TPE filters in pediatric patients.
  • To identify factors contributing to technical and clinical complications during pediatric TPE.
  • To provide age-specific safety insights for pediatric TPE procedures.

Main Methods:

  • Retrospective cohort study of pediatric TPE patients over 25 years.
  • Analysis of 740 procedures in 178 patients at a level 3 referral center.
  • Inclusion of vascular access and membrane-based TPE filter data.

Main Results:

  • Technical complications occurred in 20.8% of procedures, significantly more than clinical complications (4.2%).
  • Each additional day of catheter use increased technical complication risk by 3%.
  • Fresh frozen plasma (FFP) supplementation increased clinical complication risk by 21.6%, while older age decreased it.

Conclusions:

  • Prolonged catheter dwell time is associated with increased technical complications in pediatric TPE.
  • FFP supplementation is linked to a higher risk of clinical complications.
  • Age is a significant factor, with older pediatric patients experiencing fewer clinical complications, emphasizing tailored safety approaches.
Abstract

Keywords:
central catheterchildrenclinical adverse effectsfiltertechnical adverse effectstherapeutic plasma exchange

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