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

Abstract

Objective: To assess the safety, efficacy and outcomes of therapeutic plasma exchange (TPE) in children.

Methods: Data were retrieved from hospital records for all children £18 years who underwent TPE between August, 2011 and July, 2018.

Results: 46 children [median (range) age 96 (8-204) months] underwent 293 sessions of TPE by membrane plasma separation technique. Renal disease was the commonest indication (24, 52.2%) followed by neurological illnesses (17; 36.9%). 36 (78.2%) patients belonged to American Society for Apheresis category I. Overall, the most common indication was atypical hemolytic uremic syndrome (aHUS) (16; 34.8%). Fresh frozen plasma plus albumin was used as replacement fluid in aHUS, while albumin was used in others. 40 (86.9%) patients had complete/partial recovery while six did not show any sign of recovery. Complications were seen in 21 (7.1%) sessions; majority of which were minor in the form of blood pressure fluctuations.

Conclusion: TPE can be performed safely and effectively for renal and non-renal indications, even in small children.