Complications of therapeutic apheresis in children

Kara, Abdurrahman; Turgut, Seda; Cagli, Adnan; Şahin, Fikret; Oran, Erkut; Tunç, Bahattin

doi:10.1016/j.transci.2013.04.020

Cited by 29 publications

(22 citation statements)

References 3 publications

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“…As inadequate venous access is an obstacle to long‐term aRBX, and because our policy is to avoid the systematic use of a central venous line, we have selected for our aRBX program only patients who have an adequate peripheral access. Indeed, as is the case for other therapeutic apheresis, venous access is a major issue for patients, particularly for children requiring chronic exchange transfusion program . A long‐term central venous line could be considered, but a double‐lumen catheter with high flow is needed and may be associated with infections, thrombosis, and difficulties in blood withdrawal .…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, as is the case for other therapeutic apheresis, venous access is a major issue for patients, particularly for children requiring chronic exchange transfusion program. 39,40 A long-term central venous line could be considered, but a double-lumen catheter with high flow is needed and may be associated with infections, thrombosis, and difficulties in blood withdrawal. 41 A permanent central line also requires appropriate regular care, represents a discomfort in daily life, and might be associated with a higher risk of thrombosis in patients with SCD.…”

Section: Discussionmentioning

confidence: 99%

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AutomatedRBCexchange compared to manual exchange transfusion for children with sickle cell disease is cost‐effective and reduces iron overload

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

AutomatedRBCexchange compared to manual exchange transfusion for children with sickle cell disease is cost‐effective and reduces iron overload

et al. 2018

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“…The immediate complication rates associated with TPE in our cohort was minimal at 13.8% (18/130 procedures). There was a reported variance of 3–55% in complications associated with TPE in children and adults in the literature . Michon et al.…”

Section: Discussionmentioning

confidence: 99%

“…The immediate complication rates associated with TPE in our cohort was minimal at 13.8% (18/130 procedures). There was a reported variance of 3-55% in complications associated with TPE in children and adults in the literature (19,20). Michon et al reported a higher incidence of 55% of complication-related apheresis in children (19) and concluded that these procedures should be performed in special centers only.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of Pediatric Plasma Apheresis in Intensive Care Settings

et al. 2014

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Therapeutic plasma apheresis or exchange (TPE) in the pediatric population is technically challenging. Moreover, there is generally an apprehension in using TPE in children compared to adults. Recently, usage of TPE has evolved and is now being used in heterogenous clinical conditions. Its usefulness is classified by the American Society for Apheresis (ASFA) into various categories ranging from I to IV. The objective of this paper was to review the procedure in context of clinical indications, complications and outcomes in children. For this purpose, we retrospectively reviewed all TPE procedures performed on inpatients of 3 to 16 years of age during a 6-year period (2007-2012). A total of 130 procedures were performed on 28 patients (M : F ratio of 1:1) with median age (range) of 8.8 (4-16) years. All procedures were done using the continuous cell-separator centrifugal method. Due to organ dysfunctions, the majority of procedures (N = 26 of 28 or 92% patients) were performed in the pediatric intensive care unit. Twenty-three, four and one patient belonged to ASFA categories I, II and III, respectively. The most common indications were neurological disorders (N = 13 or 46.4%), comprised of Guillain-Barré syndrome (N = 10) and myasthenia gravis (N = 3). Hematological disorders (N = 10 or 35.7%) including thrombotic thrombocytopenic purpura-hemolytic uremic syndrome were a close second. Complete recovery was seen in 23 patients (84%). Trivial adverse effects were observed in 18/130 (13.8%) procedures. Major complications including cardiac arrest, hypotension and transfusion-related acute lung injury were observed in 5/130 or 3.8% of procedures. However, there was no procedure-related death though five patients died during treatment due to underlying pathology. In conclusion, TPE is a safe and effective option in sick children for appropriate indications. An experienced staff with sound procedural skills is imperative for successful therapy.

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“…The excess of adverse reactions in children are mostly related to citrate toxicity, higher relative vascular volume shifts, and the need for vascular access [33]. In a study by Kara et al complications were observed in four out of 14 patients which were minimal and were vascular access complication because of insufficient flow, abdominal pain and chilling [35]. Haque et al has also observed trivial adverse effects in 18/130 (13.8%) procedures in pediatric patients in intensive care units [36].…”

mentioning

confidence: 99%