SCOPE AND SAFETY OF THERAPEUTIC PLASMA EXCHANGE BY CENTRIFUGATION IN PEDIATRIC PATIENTS: EXPERIENCE AT A TERTIARY CARE HOSPITAL IN WESTERN INDIA

Abstract

Introduction

Therapeutic Plasma Exchange (TPE) is a well-known therapeutic modality for treating various pediatric diseases. However, no special guidelines are available for pediatric patients, and adult guidelines- American Society for Apheresis (ASFA) are followed.

Aim: To study the safety of TPE and analyze the various indications for which it can be done in pediatric patients.

Material and Methods: A 5-year retrospective analysis of the indications and their safety was done from 2018 to 2022.TPE was done by centrifugation

Results: TPE was performed in 120 patients and 926 procedures were done. Antibody-mediated rejection (ABMR) and Atypical Hemolytic uremic syndrome (a HUS) were the most common indications with 42.5% of procedures each. Pre-Renal transplant desensitization (8.3%) and Wilsons disease (2.5%) were other indications. The most common adverse event seen was moderate (53.57%), and allergic reaction to replacement fluid -Fresh Frozen Plasma (FFP) was the most common. Vomiting was the most common adverse event in the severe (42.85%) category and 3.57% of adverse events were mild. The most common indication where adverse events were seen was a HUS followed by ABMR.

Conclusion: TPE by centrifugation is safe in pediatric patients However, a separate guideline for pediatric patients to categorize the indications is required.