Complications of apheresis in children

Michon, Bruno; Moghrabi, Albert; Winikoff, Rochelle; Barrette, Stéphane; Bernstein, Mark L.; Champagne, Josette; David, Michèle; Duval, Michel; Hume, Heather; Robitaille, Nancy; Bélisle, André; Champagne, Martin A.

doi:10.1111/j.1537-2995.2007.01405.x

Cited by 155 publications

(164 citation statements)

References 24 publications

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“…Moreover, plasmapheresis is not without risk [16]. The justification for urgent treatment when the etiological diagnosis is unknown is the high risk of early death, irreversible kidney damage, or the risks associated with prolonged disease activity [5,6].…”

Section: Discussionmentioning

confidence: 99%

Atypical hemolytic uremic syndrome with MCP mutations preceded by respiratory infection

Yasuda

Sasaki²,

Yamato³

et al. 2012

CEN Case Rep

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A 14-year-old boy was referred to our hospital with general fatigue and sore throat. A chest X-ray and computed tomography revealed diffuse bilateral bronchitis. A laboratory examination showed anemia, thrombocytopenia, and renal insufficiency. He had a past medical history of hemolytic uremic syndrome (HUS) without diarrhea at the age of 3; moreover, his elder brother suffered from HUS at the age of 12. These findings indicated that the patient had a familial relapsing form of HUS (atypical HUS). Therefore, he was immediately treated with plasma exchange (PE), as suggested by guidelines, obtaining complete remission. Fifteen months later, he suffered another relapse of atypical HUS preceded by respiratory infection and was cured again with PE. His ADAMTS-13 activity was normal and its inhibitory antibody was undetectable. Two different mutations were found in the gene encoding membrane cofactor protein (MCP). Respiratory infections preceded all three episodes of HUS, but we could not detect the pathogenic agent. Although the longterm outcomes of patients with atypical HUS who have mutations in the MCP gene appear favorable, recurrences are nevertheless frequent. Few reports have described Japanese patients with atypical HUS and complement regulatory abnormalities. This is the first report of a Japanese patient with atypical HUS and mutations in the MCP gene.

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Section: Discussionmentioning

confidence: 99%

Atypical hemolytic uremic syndrome with MCP mutations preceded by respiratory infection

Yasuda

Sasaki²,

Yamato³

et al. 2012

CEN Case Rep

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“…In one series of pediatric apheresis patients, most of whom had tunneled central access for their procedures, catheter-associated thrombosis occurred in 12.4 % of patients (1.7 % of procedures) and infection (positive blood culture) occurred in 16.1 % of patients (2.1 % of procedures) [110]. This rate of infection (antibiotic course given) is lower than that reported for pediatric hemodialysis patients with indwelling central venous catheters (9 % of procedures) [111].…”

Section: Accessmentioning

confidence: 99%

“…Children appear to be at higher risk for complications, including more hypotension, symptomatic hypocalcemia, allergic reactions, severe anemia and catheter infection or thrombosis, affecting up to 55 % of procedures and 82 % of patients. Lower body weight, higher number of procedures and lower hemoglobin were associated with more events [110]. The most common adverse reactions (hypotension secondary to high extracorporeal volume, citrate toxicity and catheter-related complications) are discussed above.…”

Section: Replacement Fluidsmentioning

confidence: 99%

“…Identifiable risk factors for hypotension include low patient weight, young age, renal disease, absence of blood primer and hypocalcemia [110]. Whether the patient can tolerate the removal of a large red cell mass without any compromise of their oxygen delivery must be determined based on the clinical circumstances, including volume status, cardiovascular status and hematocrit prior to the procedure.…”

Section: Extracorporeal Blood Volumementioning

confidence: 99%

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Therapeutic plasma exchange for the treatment of pediatric renal diseases in 2013

Carter

Benador

2013

Pediatr Nephrol

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Therapeutic plasma exchange is an extracorporeal treatment modality that removes systemic circulating pathologic factors or replaces absent plasma components and plays a role in many nephrologic conditions. It presents a number of technical challenges in the pediatric population but has become an increasingly common practice in pediatric nephrology over the past several decades. While prospective evidence is often lacking, our increased understanding of the molecular pathogenesis underlying many pediatric renal diseases provides sound reasoning for the use of plasma exchange in treating these conditions. This review will present the currently accepted indications for plasma exchange in children, the technical aspects of the procedure and its potential complications.

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“…Also, blood product transfusion during plasma exchange exposes patients to the additional risks of viral infection and transfusionrelated acute lung injury. Furthermore, Catheter-related complications are also reported and include access thrombosis and infection [6]. Due to paucity of data about the outcome of TPE in our unit, we designed this cross sectional study aiming to assess its outcome in treating different immunological and nonimmunological disorders during one year period.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Therapeutic Plasma Exchange; One Year Single Center Experience

Ghonemy¹

2016

UNOAJ

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Background: Outcome of therapeutic plasma exchange (TPE) in treating different immunological and non-immunological diseases in our unit is not clear. We aimed to study the outcome TPE in different diseases categories during one-year period.Methods: Prospective cross sectional study of patients referred for TPE during one year period. Demographic, clinical data, number of sessions, volume of plasma exchanged, patient tolerance and complications during or post to the procedure were systematically recorded and descriptive statistics applied for analysis.

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Complications of apheresis in children

Abstract: Pediatric apheresis presents unique challenges and is associated with higher complication rate compared to adults. It is recommended that this procedure be performed in specialized centers.

Cited by 155 publications

References 24 publications

Atypical hemolytic uremic syndrome with MCP mutations preceded by respiratory infection

Atypical hemolytic uremic syndrome with MCP mutations preceded by respiratory infection

Therapeutic plasma exchange for the treatment of pediatric renal diseases in 2013

Outcomes of Therapeutic Plasma Exchange; One Year Single Center Experience

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