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Centrifugal Therapeutic Plasma Exchange in Pediatric Patients

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Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objective

To assess the safety of centrifugal therapeutic plasma exchange (TPE) in pediatric patients.

Methods

The authors did a retrospective analysis of all TPE procedures performed in pediatric patients over a period of 19 y (2001–2019). Procedures were done on different apheretic devices, daily or on alternate days depending on the clinical condition of the patient. Adverse events during the procedure were noted and analyzed.

Results

A total of 672 TPE (with mean of 6.77 ± 4.85) procedures were performed for 99 pediatric patients with different indications like hematological (n = 68), renal (n = 12), neurology (n = 18) and hepatology (n = 1). The mean age was 7.00 ± 3.11 y and weight was 20.72 ± 9.17 kg. Adverse events (AEs) were observed during 34 (5%) procedures, most common were allergic reactions to replacement fluid (2.24%) followed by hypotension (1.04%), symptomatic hypocalcemia (1.04%), line occlusion (0.59%), and febrile non hemolytic transfusion reaction (0.41%). A significant correlation of AEs was observed with weight (p = 0.045), total blood volume of the patient (p = 0.04), increasing number of procedures (p = 0.000) and replacement fluid [Fresh frozen plasma (FFP)] (p = 0.04). All AEs were managed as per departmental standard operating procedures (SOPs) completing procedures successfully except one which was abandoned. No mortality was observed during the procedures.

Conclusion

TPE is a safe therapeutic modality in pediatric patients when performed under expert technical supervision with proper SOPs in place.

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Authors and Affiliations

  1. Department of Transfusion Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Rekha Hans, Divjot Singh Lamba, Satya Prakash, Parmatma Prasad Tripathi, Ratti Ram Sharma & Neelam Marwaha

  2. Department of Pediatric Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Karalanglin Tiewsoh, Lesa Dawman & Naveen Sankhyan

Authors
  1. Rekha Hans
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  2. Karalanglin Tiewsoh
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  3. Divjot Singh Lamba
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  4. Lesa Dawman
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  5. Satya Prakash
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  6. Parmatma Prasad Tripathi
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  7. Naveen Sankhyan
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  8. Ratti Ram Sharma
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  9. Neelam Marwaha
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Contributions

RH: Data acquisition, compilation, and data analysis, drafting the work and writing of manuscript; DSL, SP, PPT, KT and LD: Data generation and data compilation, revising it critically; NS: Revising it critically for important intellectual content; RRS and NM: Approving the version to be published. RRS will act as guarantor for this paper.

Corresponding author

Correspondence to Ratti Ram Sharma.

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The manuscript was presented as poster at 29th Regional Congress of the International Society of Blood Transfusion (ISBT), Basel, Switzerland held from 22–26 June 2019 and abstract was published in Vox Sanguinis 2019: 114 (Suppl. 1) as abstract number 211

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Hans, R., Tiewsoh, K., Lamba, D.S. et al. Centrifugal Therapeutic Plasma Exchange in Pediatric Patients. Indian J Pediatr 88, 757–763 (2021). https://doi.org/10.1007/s12098-020-03657-6

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  • DOI: https://doi.org/10.1007/s12098-020-03657-6

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