An international survey of paediatric apheresis practice

Abstract

IntroductionPaediatric apheresis (PA) has distinct characteristics compared to adult apheresis and requires specialized knowledge and experience to perform safely, particularly in low‐weight patients. As evidence‐based medicine advances the field of therapeutic apheresis, increased attention must be paid to paediatric patients with conditions for which apheresis is indicated.MethodsAn electronic survey of >5000 potential participants throughout the world was conducted to ascertain the scope and the current state of practice.ResultsThe survey elicited 159 responses from 12 countries; 107 of the responses provided sufficient information for analysis. Participants performed an average of 176 PA procedures/year (range 1–2000). The types of PA procedures were therapeutic plasma exchange (TPE, 92% of centres), red cell exchange (RCE, 86%), leucocyte depletion (LD, 87%) and peripheral blood hematopoietic progenitor cell collection (HPC, 72%). More than 65% of the centres had treated children older than 5 years with PA. Many centres had also performed PA on younger children; 40% have treated patients <12 months of age; 61% had treated patients 1–5 years old. About 36% of centres reported that they would perform apheresis regardless of patient weight; 18% used a 5 kg threshold, 11% used 5–10 kg and 17% used 10 kg as their weight threshold.ConclusionThis report is the largest single survey of centres performing PA. The results provide information about the scope and diversity of PA and identify areas where considerable variability in practice exists. Further exploration of these differences could establish best practices in PA through international research and collaboration.