Abstract
Acute renal failure is not an uncommon complication following stem cell transplantation (SCT) and requires blood purification therapy (BPT) to obtain space for transfusion and replace renal function. Twenty-three pediatric patients received allogeneic SCT in a recent 3-year-period at our hospital. Of these, we reviewed the records of 4 patients who underwent BPT for acute renal failure following SCT. The age of the patients was 8 years (7-12 years, median and range). The patients had ≥10% fluid overload after 30days (7-46days) of SCT. Days to BPT after SCT were 40days (34-80days), and BPT was performed for 6days (1-11days). During the procedure, 2.4L (1.2-39L) of fluids were removed and 2.4L (1.7-7.5L) of fluids were transfused. In all patients, hemoglobin and platelet count increased, and serum urea nitrogen and creatinine decreased. However, all patients died from multiorgan failure without termination of BPT. Although BPT for acute renal failure was useful in pediatric SCT patients to provid space for transfusion and replace renal function, aggressive management of fluid overload and earlier initiation of BPT for these patients were considered necessary to improve the outcome.
