Report of 63 cases of pediatric plasma exchange therapy in our department

Abstract

Since the introduction of plasma exchange (PE) therapy in children in December 2007, we experienced 63 children requiring PE therapy (male: female, 41: 22; mean age, 29.5±20.1 months) up to August 2013. Among these children, PE therapy was undertaken in 51 children (80%) with Kawasaki disease, and the other diseases requiring PE therapy were fulminant hepatitis, multiple organ failure accompanied by sepsis, and juvenile idiopathic arthritis. PE therapy was performed 4.0±1.2 times per child, with a mean maximum blood flow rate of 60.0±13.3 mL/min. Many of the pediatric-specific problems found through accumulated cases have been overcome, and the current method of performing PE therapy allows better vascular access, priming of the circuit, anticoagulant administration, sedation, etc. The use of PE therapy and the number of diseases in which it is being used have increased annually. Through our experiences, we aim for safer and faster PE therapy.