The performance of Plasmaphreresis Unit in Ali-asghar children hospital- an audit

Background and aim: Therapeutic plasmapheresis is a method in which a large amount of plasma is removed from the body and replaced by 4.5% plasma or albumin solution. It helps to reduce the concentration of proteins, fats, toxins, antigens and antibodies and immune complexes such as s lupus, which are involved in antibodies and immune complexes, it is possible to prevent kidney failure by removing antibodies. This is an audit of plasmaphresis unit in a children hospital.Methods: This was a retrospective descriptive study conducted between 2016 and 2017 in Ali-asghar children hospital. All patients went under plasmapheresis with Optia or Feresenius devices. The replacement fluid was Fresh Frozen Plasma with the volume of 30-40 ml/kg for at least 3 to 5 sessions in hemolytic uremic syndrome or thrombotic thrombocytopenia. For other patients replacement fluid was a mixture of Albumin, FFP and Normal saline. Blood pump , citrate infusion ,and priming of catheter was per protocol. Results: The number of patients (13 M, 13 F) who were treated with plasmapheresis was 26 with age of 9 months to 14 years. The range of weight was 9-50 kg. The duration of plasmapheresis in each session was 50-140 minutes. The majority of patients suffered of hemolytic uremic syndrome.The observed complications were hypocalcemia, Coldness and shiver , erythema , rash , Leakage of blood around exit site that happened in 9 children. Two sessions membrane were ruptured or device was out of order. Catheter malfunction, ineffective plasmapheresis were other complications.Conclusion: this was the first report of plasmapheresis unit in Iran. The rate of complication was low and it was safe in small children