Review Article|Articles in Press, 103679

Apheresis in pediatric patients: Current differences and difficulties

Published:February 24, 2023DOI:
      Pediatric patients require tailored therapy adjusted to their age and condition and someone to stand for their rights as they are politically vulnerable. Apheresis procedures performed on the pediatric patient group is challenging like elderly or pregnant patients. Differences from adult group and difficulties during the apheresis procedure may be discussed in four major groups: lack of evidence for apheresis in pediatrics, rapidly changing body weight and height alongside small proportions of newborns and infants, continuous embodiment and development of organ systems forcing health care providers to pay extra attention for chemical exposure and side effects, and current apheresis technical hardware are designed for adults not for pediatric age groups. On top of that, psychological issues are something to remember for care givers e.g., to keep children calm in their beds during procedure.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Transfusion and Apheresis Science
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Padmanabhan A.
        • Connely -Smith L.
        • Aqui N.
        • Balogun R.A.
        • Klingel R.
        • Meyer E.
        • et al.
        Guidelines on the use of therapeutic apheresis in clinical practice - evidence based approach from the writing committee of the american society for apheresis (ASFA): the eighth special issue.
        J Clin Apher. 2019; 34: 171-354
        • Long E.J.
        • Shann F.
        • Pearson g, Buckley D.
        • Butt W.
        A randomized controlled trial of plasma filtration in severe pediatric sepsis.
        Crit Care Resusc. 2013; 15: 198-204
        • Fortenberry J.
        • Nguyen T.
        • Grunwell J.
        • Aneja R.
        • Wheeler D.
        • Hall M.
        • et al.
        Therapeutic plasma exchange in children with thrombocytopenia-associated multiple organ failure: the thrombocytopenia-associated multiple organ failure network prospective experience.
        Crit Care Med. 2019; 47 (March): e173-e181
        • Meyer E.
        • Wong E.
        Pediatric therapeutic apheresis: a critical appraisal of evidence.
        Transfus Med Rev. 2016; 30: 217-222
        • Worel N.
        • Taleghani B.M.
        • Strasser E.
        Recommendations for therapeutic apheresis by the section ‘’ preparative and therapeutic hemapheresis’’ of the German society for transfusion medicine and immunohematology.
        Transfus Med Hemother. 2019; 46: 394-406
        • Abe T.
        • Matsuo H.
        • Abe R.
        • Abe S.
        • Asada H.
        • Ashida A.
        • et al.
        The Japanese society for apheresis clinical practice guideline for therapeutic apheresis.
        Ther Apher Dial. 2021; 25: 728-876
        • Perotti C.
        • Seghatchian J.
        • Del Fante C.
        Pediatric apheresis emergencies and urgencies: An update.
        Transfus Apher Sci. 2018; 57: 339-341
        • Wong E.
        • Balogun R.
        Therapeutic apheresis in pediatrics: technique adjustments, indications and nonindications, a plasma exchange focus.
        J Clin Apher. 2012; 27: 132-137
      1. Dunbar N, translated by Altuntaş F. Aferez: İlkeler ve uygulama: 4. Baskı cilt 1. terapötik Aferez, 2020.
        • Linderkamp O.
        • Vershmold H.T.
        • Riegel K.P.
        • et al.
        Estimation and prediction of blood volume in infants and children.
        Eur J Pedia. 1977; 125: 227-234
        • Taylan C.
        • Schaaf A.
        • Dorn C.
        • Schmitt C.
        • Loos S.
        • Kanzelmeyer N.
        Safety of therapeutic apheresis in children and adolescents.
        Front Pediatr. 2022; 10850819