Therapeutic Plasma Exchange in Children: A Preliminary Review

Abstract

Therapeutic plasma exchange (TPE) has been a key immunotherapeutic strategy in numerous neurological syndromes, predominantly during the acute phase of illness.The rarity of these immunological disorders in children, combined with a lack of understanding of their pathobiology, has hampered the creation of a solid scientific rationale for TPE therapy and the practicality of larger controlled studies. TPE is still used, but it's a pricey treatment with a lot of side effects. Uncertainty persists over how to compare the various TPE procedures, the best therapeutic dosage, and TPE monitoring and integration with other immunotherapies. The extracellular component of blood (plasma) is extracted from the cellular component (plasmapheresis), replaced with a colloid or crystalloid substitute, reintegrated with the cellular component, and returned to the patient in therapeutic plasma exchange (TPE). The goal of treatment is to get rid of potential illness mediators such toxic macromolecules and pathogenic autoantibodies from the body. The method was first described in the early twentieth century, and by the early 1970s, it was widely available for therapeutic application. Since then, the list of therapy indications has grown dramatically, with neurological diseases accounting for a sizable share. However, only 13.4 percent of children admitted for category I (first-line) American Society for Apheresis (ASFA) indications and 9.3 percent of those admitted for category II (second-line) indications received TPE, according to a recent survey of 42 North American Paediatric hospitals that provide the treatment.