Indian pediatrics · 2025
Therapeutic Plasma Exchange in Pediatric Care: Insights from a Tertiary Care Centre Experience.
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Chowdhary Sphurti, Gulla Krishna Mohan, Prakash Satya, Sahu Ansuman, Panda Sandip, Satapathy Amit Kumar
Аннотация
OBJECTIVE: To assess the safety, efficacy and outcomes of therapeutic plasma exchange (TPE) in children at a tertiary care hospital.
METHODS: Data of children who underwent TPE between January 2020 and July 2024 at a tertiary care hospital in Eastern part of India, were collected from the hospital records and analyzed.
RESULTS: Forty children with mean (SD) age of 7.5 (3) years underwent 184 cycles of TPE during the study period. Liver disease was the commonest indication (n=14, 35%) followed by renal diseases (n=11, 27.5%) and secondary hemophagocytic lymphohistiocytosis (HLH, n=9, 22.5%). Out of 40 children,16 were discharged, 21 succumbed to the illness and 3 left against medical advice. Children with autoimmune encephalitis and renal diseases with American Society for Apheresis (ASFA) category I indication for TPE had an excellent outcome as compared to others. However, a high mortality was observed in view of delayed presentation with organ failure and lack of liver transplant facility.
CONCLUSION: TPE is an effective treatment in hemolytic uremic syndrome (HUS) and anti-N-methyl-D-aspartate receptor encephalitis. TPE can be performed safely and effectively for renal and non-renal indications.
METHODS: Data of children who underwent TPE between January 2020 and July 2024 at a tertiary care hospital in Eastern part of India, were collected from the hospital records and analyzed.
RESULTS: Forty children with mean (SD) age of 7.5 (3) years underwent 184 cycles of TPE during the study period. Liver disease was the commonest indication (n=14, 35%) followed by renal diseases (n=11, 27.5%) and secondary hemophagocytic lymphohistiocytosis (HLH, n=9, 22.5%). Out of 40 children,16 were discharged, 21 succumbed to the illness and 3 left against medical advice. Children with autoimmune encephalitis and renal diseases with American Society for Apheresis (ASFA) category I indication for TPE had an excellent outcome as compared to others. However, a high mortality was observed in view of delayed presentation with organ failure and lack of liver transplant facility.
CONCLUSION: TPE is an effective treatment in hemolytic uremic syndrome (HUS) and anti-N-methyl-D-aspartate receptor encephalitis. TPE can be performed safely and effectively for renal and non-renal indications.