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Critical Care Pediatric Nephrology and Dialysis: A Practical Handbook pp 139–170Cite as

Plasmapheresis in Pediatric Renal Disease

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Abstract

Plasmapheresis or therapeutic plasma exchange has been known to be useful either as a first-line treatment or a second-line therapy in pediatric renal disease. Data is limited in children, and the vast majority of the data is extrapolated from adult-based evidence. Of the many kidney diseases in children, TPE may be beneficial in a small number of diseases. These include glomerular disease with a rapidly progressive form, such as ANCA-associated rapidly progressive glomerulonephritis; anti-glomerular basement membrane (anti-GBM) disease (Goodpasture’s syndrome); nephrotic syndrome such as focal segmental glomerulosclerosis (FSGS), specifically after recurrence in kidney transplant; thrombotic microangiopathy (primary or secondary; and ABO incompatible kidney transplant or antibody-mediated rejection. This chapter reviews therapeutic apheresis with emphasis on special technical considerations unique to pediatric patients, including securing adequate vascular access, maintaining desired intravascular volume and circulating red cell mass, and preventing complications by early recognition of adverse reactions. Clinical applications of plasmapheresis in pediatric patients with renal diseases are discussed on the basis of evidence utilizing the American Society for Apheresis (ASFA) guidelines. Furthermore, the most current data on plasmapheresis in renal diseases, the indications and plasmapheresis treatment approach, as well as specific technical considerations in children are presented.

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Authors and Affiliations

  1. Division of Nephrology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Daniella Levy-Erez

  2. Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Daniella Levy-Erez & Haewon C. Kim

  3. Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Haewon C. Kim

  4. Department of Pathology and Laboratory Medicine, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Haewon C. Kim

Authors
  1. Daniella Levy-Erez
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  2. Haewon C. Kim
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Correspondence to Haewon C. Kim .

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Editors and Affiliations

  1. Kidney & Urology Institute, Medanta, The Medicity Kidney & Urology Institute, Gurugram, Haryana, India

    Sidharth Kumar Sethi

  2. Department of Nephrology, Cleveland Clinic Akron General Medical center and Akron Children’s Hospital, Akron, OH, USA

    Rupesh Raina

  3. Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa

    Mignon McCulloch

  4. Pediatric Nephrology, Children’s Hospital of Richmond at the Virginia Commonwealth University, Richmond, VA, USA

    Timothy E. Bunchman

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Levy-Erez, D., Kim, H.C. (2019). Plasmapheresis in Pediatric Renal Disease. In: Sethi, S., Raina, R., McCulloch, M., Bunchman, T. (eds) Critical Care Pediatric Nephrology and Dialysis: A Practical Handbook. Springer, Singapore. https://doi.org/10.1007/978-981-13-2276-1_13

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