title: [Apheresis in children: procedures and outcome].
abstract: Apheresis procedures are used in children to treat an increasing number of conditions by removing different types of substances from the bloodstream. In a previous study we evaluated the first results of our experience in children, emphasizing the solutions adopted to overcome technical difficulties and to adapt adult apheresis procedures to a pediatric population. The aim of the present study is to present data on a larger number of patients in whom apheresis was the main treatment. Ninety-three children (50 m, 43 f) affected by renal and/or extrarenal diseases were included. They were treated with LDL apheresis, protein A immunoadsorption, or plasma exchange. Our therapeutic protocol was the same as described in the previous study. Renal diseases and immunological disorders remained the most common conditions requiring this therapeutic approach. However, hemolytic uremic syndrome (HUS) was no longer the most frequent renal condition to be treated, as apheresis is currently the first treatment option only in cases of atypical HUS. In this series we also treated small children, showing that low weight should no longer be considered a contraindication to apheresis procedures. The low rate of complications and the overall satisfactory clinical results with increasingly advanced technical procedures make a wider use of apheresis in children realistic in the years to come.
authors.affiliation: U.O. Nefrologia e Dialisi Pediatrica, Ospedale Pediatrico Giovanni XXIII, Bari, Italy. albinatummolo@yahoo.it
authors.forename: Albina
authors.initials: A
authors.lastname: Tummolo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Colella
authors.forename: Rosa
authors.initials: R
authors.lastname: Bellantuono
authors.forename: Mario
authors.initials: M
authors.lastname: Giordano
authors.forename: Giovanni
authors.initials: G
authors.lastname: Messina
authors.forename: Flora
authors.initials: F
authors.lastname: Puteo
authors.forename: Palma
authors.initials: P
authors.lastname: Sorino
authors.forename: Tommaso
authors.initials: T
authors.lastname: De Palo
mesh_terms: D000293:Adolescent; D000744:Anemia, Hemolytic, Autoimmune / Q000628:therapy; D001781:Blood Component Removal / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000628:therapy; D006801:Humans; D007154:Immune System Diseases / Q000628:therapy*; D007223:Infant; D007674:Kidney Diseases / Q000628:therapy*; D008077:Lipoproteins, LDL / Q000097:blood; D017114:Liver Failure, Acute / Q000628:therapy; D008180:Lupus Erythematosus, Systemic / Q000628:therapy; D008297:Male; D008659:Metabolic Diseases / Q000628:therapy; D009422:Nervous System Diseases / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome; D014657:Vasculitis / Q000628:therapy
chemical_list: D008077:Lipoproteins, LDL