Journal of Artificial Organs

, Volume 20, Issue 3, pp 236–243 | Cite as

Plasma exchange for the patients with dilated cardiomyopathy in children is safe and effective in improving both cardiac function and daily activities

  • Takeshi Moriguchi
  • Keiichi Koizumi
  • Kenichi Matsuda
  • Norikazu Harii
  • Junko Goto
  • Daiki Harada
  • Hisanori Sugawara
  • Minako Hoshiai
  • Hiroaki Kise
  • Akiyasu Baba
Original Article Apheresis
  • 168 Downloads

Abstract

Autoantibodies against cardiac proteins play an important role in the development of dilated cardiomyopathy (DCM). The efficacy and safety of apheresis such as immunoadsorption (IA) or plasma exchange (PE) to remove such antibodies have been reported in adult DCM patients. However, apheresis for pediatric DCM has not been performed because of technical difficulty due to relatively low blood volume and instability of hemodynamics. As we have experiences of preforming apheresis on hemodynamically unstable children, we have preformed ten courses of PE on seven child DCM patients including both patients in chronic and acute phase to assess the safety and efficacy to PE. Under general anesthesia, the patients were administered PE three times during 3 days as 1 course. Simultaneously, continuous hemodiafiltration (CHDF) was performed in series with the PE circuit to stabilize hemodynamic status and to minimize the adverse effects of PE. The changes in LVEF, CTR, mBP, the dosage of furosemide and NYHA were assessed before and after the procedure of PE. There were no severe adverse effects such as systemic bleeding or refractory hypotension due to apheresis. Echocardiography showed that mean baseline LVEF was 24.3 ± 7.8%. Mean LVEF significantly increased 1 week after PE to 30.5 ± 12.5%. CTR significantly decreased after PE. Mean BP significantly increased 1 month after PE (54.5 ± 10.7 to 60.7 ± 9.8 mmHg). NYHA improved after PE significantly (NYHA; 3.4 ± 1.1 to 2.5 ± 1.1). PE is safe and effective in improving both cardiac function and daily activities.

Keywords

Dilated cardiomyopathy Child Apheresis Plasma exchange CHDF 

Notes

Acknowledgements

I appreciate prof. Kanji Sugita, M.D., Ph.D., Takako Toda MD (University of Yamanashi School of Medicine, Department of Pediatrics) for conducting the present study. I appreciate Brittany Davis and Andrew Taylor for an act of proofreading. This study is supported by Yamanashi University research endowment program.

Compliance with ethical standards

Conflict of interest

There are no conflicts of interest, including related consultancies, shareholdings and funding grants.

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Copyright information

© The Japanese Society for Artificial Organs 2017

Authors and Affiliations

  • Takeshi Moriguchi
    • 1
  • Keiichi Koizumi
    • 2
  • Kenichi Matsuda
    • 1
  • Norikazu Harii
    • 1
  • Junko Goto
    • 1
  • Daiki Harada
    • 1
  • Hisanori Sugawara
    • 1
  • Minako Hoshiai
    • 2
  • Hiroaki Kise
    • 2
  • Akiyasu Baba
    • 3
  1. 1.Department of Emergency and Critical Care MedicineUniversity of Yamanashi School of MedicineChuoJapan
  2. 2.Department of PediatricsUniversity of Yamanashi School of MedicineChuoJapan
  3. 3.Department of CardiologyTokyo Dental College Ichikawa General HospitalIchikawaJapan

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