Therapeutic Plasma Exchange does not Improve Renal Function in Hematopoietic Stem Cell Transplantation-Associated Thrombotic Microangiopathy: An Institutional Experience

Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
Sarah SartainCaridad Martinez

Abstract

Transplantation-associated thrombotic microangiopathy (TA-TMA) is a complication of hematopoietic stem cell transplant (HSCT) that causes severe multiorgan injury. The kidneys are almost universally affected. There is no proven therapy, but therapeutic plasma exchange (TPE) is commonly used to treat TA-TMA at Texas Children's Hospital (TCH). To date, there have been no studies assessing the long-term efficacy of TPE in preventing the development of chronic kidney disease (CKD) in TA-TMA patients. In this study we retrospectively analyzed the incidence of CKD in TA-TMA pediatric patients treated with TPE to determine if this treatment modality improves renal morbidity. We reviewed records between January 2007 and June 2017 of pediatric HSCT patients diagnosed with TA-TMA, identified through an internal database maintained at TCH. To be included patients must have completed a course of TPE per the "TPE in TA-TMA" institutional protocol at TCH. CKD was defined as kidney damage for at least 3 months and stratified into stages 1 through 5 according to estimated glomerular filtration rate. Stages 4 and 5 were considered "severe CKD." In the 10-year timeframe 15 patients with TA-TMA completed a course of TPE per our institutional prot...Continue Reading

Citations

Sep 17, 2019·Current Opinion in Critical Care·Rimda WanchooKenar D Jhaveri
Feb 25, 2020·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Zhenzhen XuJianyu Weng
May 27, 2020·Translational Research : the Journal of Laboratory and Clinical Medicine·Monica A BrayRolando E Rumbaut
Apr 17, 2021·Translational Oncology·Patrícia ValérioJosé Maximino Costa
May 16, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Shweta ShahPoyyapakkam Srivaths
Jul 25, 2021·Journal of Clinical Medicine·Sjoerd A M E G Timmermans, Pieter van Paassen
Sep 18, 2021·Current Opinion in Hematology·Michelle SchoettlerLeslie Lehmann
Jan 15, 2019·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Michelle SchoettlerChristine Duncan

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