Indications, technique, and outcome of therapeutic apheresis in European pediatric nephrology units

Fabio Paglialonga, Claus Peter Schmitt, Rukshana Shroff, Karel Vondrak, Christoph Aufricht, Alan Rees Watson, Gema Ariceta, Michael Fischbach, Gunter Klaus, Tuula Holtta, Sevcan A. Bakkaloglu, Alexandra Zurowska, Augustina Jankauskiene, Johan Vande Walle, Betti Schaefer, Elizabeth Wright, Roy Connell, Alberto Edefonti

Research output: Contribution to journalArticle

Abstract

Background: Few observations on apheresis in pediatric nephrology units have been published.

Methods: This retrospective study involved children ≤18 years undergoing plasma exchange (PE), immunoadsorption (IA), or double filtration plasmapheresis (DFPP) in 12 European pediatric nephrology units during 2012.

Results: Sixty-seven children underwent PE, ten IA, and three DFPP, for a total of 738 PE and 349 IA/DFPP sessions; 67.2 % of PE and 69.2 % of IA/DFPP patients were treated for renal diseases, in particular focal segmental glomerulosclerosis (FSGS), hemolytic-uremic syndrome (HUS), and human leukocyte antigen (HLA) desensitization prior to renal transplantation; 20.9 % of PE and 23.1 % of IA/DFPP patients had neurological diseases. Membrane filtration was the most common technique, albumin the most frequently used substitution fluid, and heparin the preferred anticoagulant. PE achieved full disease remission in 25 patients (37.3 %), partial remission in 22 (32.8 %), and had no effect in 20 (29.9 %). The response to IA/DFPP was complete in seven patients (53.8 %), partial in five (38.5 %), and absent in one (7.7 %). Minor adverse events occurred during 6.9 % of PE and 9.7 % of IA/DFPP sessions.

Conclusions: PE, IA, and DFPP are safe apheresis methods in children. Efficacy is high in pediatric patients with recurrent focal segmental glomerulosclerosis (FSGS), atypical hemolytic uremic syndrome (HUS), human leukocyte antigen (HLA) sensitization, and neurological autoimmune diseases.

Original languageEnglish
Pages (from-to)103-111
Number of pages9
JournalPediatric Nephrology
Volume30
Issue number1
DOIs
Publication statusPublished - 2015

Keywords

  • Double filtration plasmapheresis
  • Immunoadsorption
  • Pediatric apheresis
  • Plasma exchange
  • Therapeutic apheresis

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

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  • Cite this

    Paglialonga, F., Schmitt, C. P., Shroff, R., Vondrak, K., Aufricht, C., Watson, A. R., Ariceta, G., Fischbach, M., Klaus, G., Holtta, T., Bakkaloglu, S. A., Zurowska, A., Jankauskiene, A., Vande Walle, J., Schaefer, B., Wright, E., Connell, R., & Edefonti, A. (2015). Indications, technique, and outcome of therapeutic apheresis in European pediatric nephrology units. Pediatric Nephrology, 30(1), 103-111. https://doi.org/10.1007/s00467-014-2907-3