Comparative study of therapeutic plasma exchange using membrane filtration and centrifugal separation in pediatric cases

Abstract

【Objectives】In Japan, therapeutic plasma exchange (TPE) is commonly performed using the membrane filtration TPE (mTPE) method, whereas in Western countries, the centrifugal TPE (cTPE) method is more widely used. We conducted a comparative study of mTPE and cTPE in pediatric cases at our hospital. 【Methods】This study targeted cases from October 2022 to April 2024. We retrospectively analyzed the procedural conditions, type of vascular access (VA), use of general anesthesia, number of TPE sessions performed without sedation, and adverse events between the two groups. 【Results】The study included 10 mTPE cases (a total of 39 procedures) and 9 cTPE cases (a total of 42 procedures). Patient age and body weight were significantly higher, the treatment duration tended to be longer, and the volume of plasma exchanged tended to be greater in the cTPE group. In the mTPE group, endotracheal intubation and general anesthesia were required for vascular access placement in five cases, whereas no such cases were observed in the cTPE group. Notably, the number of TPE sessions performed without sedation was significantly higher with cTPE. Among adverse events, poor blood withdrawal was more common in the mTPE group, while poor blood return occurred more frequently in the cTPE group. There was no significant difference in the incidence of hypocalcemia.【Conclusion】cTPE is also a valuable treatment option in pediatric patients. It is desirable to understand its advantages and disadvantages and to appropriately distinguish its use from mTPE.