ABSTRACT 653

Abstract

Background and aims: - Aims: In this work, we will share our experiences as indications, responses and complications observed on several serious diseases perfomed therapeutic plasma Exchange (TPE) in our centre. Methods: In our centre, 51 patients and 248 TPE procedures are performed. Patients are assessed as generallygroup and in four subgroups which are according to their diagnosis, 1. group: MAHA(microangiopathic hemolytic anemia; sepsis, DIC, TAMOF, HUS, hepatitis) 2. group: MAS+HLH (Macrophage activation syndrome+Hemophagocytic Lemphohistiocytosis)3. group: Intoxications 4. group: Neurological Diseases. Organ failure and pediatric logistic organ dysfunction (PELOD) values and Glascow coma scores of all patients are documented.Also, every patient’s age,length,weight,blood group,replacement solutions and complications which are observed during TPE,intubation and extubation dates of patients whom put in practice mechanical ventilation are documented. Results: Early initiation of TPE is important in terms of survival. TPE achieved positive affect on survival of MAHA patients and well-selected cases of intoxications. To heighten the number of the platelets can be one of the aims of treatment at first group.At first group, prolongation of survival is inversely proportional to a decrease in thePELOD values and level of LDH in addition to directly proportional to an increase in Glascow coma scores. In HLH patients, waiting the rise of fibrinogen to terminate TPE is not an appropriate criteria but decrease in triglyceride levels are significant prognostic criteria in this group.Minor adverse effects were observed in 14,9 percent of the procedures. Conclusions: TPE which enhances survival on MAHA and selected patients with intoxication,is a treatment option has ever expanding indications and has low adverse effects,when it is performed with true methods.