Asian Journal of Transfusion Science
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Year : 2018  |  Volume : 12  |  Issue : 2  |  Page : 127-135

Therapeutic plasma exchange for pediatric nonrenal disease indications and outcomes: A single-center experience

1 Department of Nephrology, Apollo Hospitals, Chennai, Tamil Nadu, India
2 Department of Paediatric Intensive Care Unit, Apollo Children's Hospitals, Chennai, Tamil Nadu, India
3 Department of Paediatric Rheumatology, Apollo Children's Hospitals, Chennai, Tamil Nadu, India
4 Department of Paediatrics, Apollo Children's Hospitals, Chennai, Tamil Nadu, India

Correspondence Address:
Saravanan Margabandhu
Department of Nephrology, Apollo Hospitals, No: 21, Greams Lane, Off Greams Road, Chennai - 600 006, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajts.AJTS_123_17

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Introduction: Outcome data in pediatric plasma exchange, especially in nonrenal indications are scarce. We aimed to evaluate its role and outcome in our patients. Subjects and Methods: A retrospective study of children admitted in the year 2016 to the Pediatric Intensive Care Unit requiring plasma exchange for nonrenal indications was undertaken. Plasma exchange was given as adjunctive therapy along with primary treatment for the disease concerned. Demographic and clinical data were studied, and descriptive statistical analysis was carried out. Results: Ten children underwent plasma exchange during this 1-year period with a male: female ratio of 3:2 and a mean age of 10 years (range 3–16 years). The indications were acute disseminated encephalomyelitis (n = 2), acute neuromyelitis optica (n = 1), catastrophic antiphospholipid antibody syndrome secondary to systemic lupus erythematosus (SLE) (n = 1), severe SLE with cerebritis/hemophagocytic lymphohistiocytosis (HLH) (n = 2), severe dengue sepsis with HLH/multi-organ dysfunction syndrome (n = 2), and thrombotic microangiopathy secondary to snake bite envenomation (n = 2). All received either 1.5 or 2 times plasma volume exchange (mean sessions – 4, range = 1–6). The mean duration of stay in hospital was 17.2 days (range = 3–40 days), and follow-up was 78 days (range = 3–180 days), with the majority of children (8/10, 80%) survived from the catastrophic illness at the time of discharge. Two children (2/10, 20%) succumbed due to the disease per se in severe dengue sepsis in one and enterobacteriaceae sepsis (hospital-acquired pneumonia) in another. Conclusion: Plasma exchange was found to be beneficial as complementary therapy in a critical care setting, especially for nonrenal indications.

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2006 - Asian Journal of Transfusion Science | Published by Wolters Kluwer - Medknow
Online since 10th November, 2006