Parolin Mattia, Vidal Enrico
Nephrology, Dialysis and Transplant Unit, Department of Women's and Children's Health, University-Hospital of Padova, Padova, Italy.
Nephrology, Dialysis and Transplant Unit, Department of Women's and Children's Health, University-Hospital of Padova, Padova, Italy.
Transfus Apher Sci. 2017 Aug;56(4):510-514. doi: 10.1016/j.transci.2017.07.007. Epub 2017 Jul 10.
In the setting of kidney transplantation, therapeutic apheresis (TA) is employed both for pre-intervention procedures and during the post-transplant period. In pediatric nephrology units, TA is usually performed as a therapeutic plasma exchange (TPE) with dialysis equipment, and using non-plasma replacement fluids. In children undergoing kidney transplantation, complications of TPE are mainly related to its depletive properties combined with the iatrogenic immunodeficiency status of the patient. Moreover, the use of small central venous catheters and the equipment standardized for adults can increase the risk of adverse events. Focusing on these preconditions, TA in kidney-transplanted children should be performed in specialized centers with specific protocols and a trained staff.
在肾移植背景下，治疗性血液成分单采（TA）用于干预前程序及移植后阶段。在儿科肾脏病单元，TA通常作为治疗性血浆置换（TPE），通过透析设备并使用非血浆置换液来进行。在接受肾移植的儿童中，TPE的并发症主要与其耗竭特性以及患者的医源性免疫缺陷状态有关。此外，使用小型中心静脉导管以及成人标准化设备会增加不良事件风险。基于这些前提条件，肾移植儿童的TA应在具备特定方案和训练有素的工作人员的专业中心进行。
