Station 4 Advanced Purification: Therapeutic Plasma Exchange (TPE) Concepts & Challenges

Abstract List

20 Sep 2026 14:00 15:30
Jhao-Jhuang DingTaiwan Speaker Advanced Purification: Therapeutic Plasma Exchange (TPE) Concepts & ChallengesTherapeutic plasma exchange (TPE) is the most widely used therapeutic apheresis modality in critically ill children, yet it remains technically demanding and conceptually distinct from diffusion- and convection-based renal replacement. This hands-on station reviews the core principles of TPE—one-compartment kinetics, the rationale for a 1.0–1.5 plasma-volume exchange, and how molecular size and protein binding determine what TPE can and cannot remove—and links them to evidence-based indications from the ASFA guidelines relevant to pediatric practice (e.g., thrombotic microangiopathies, ANCA-associated and anti-GBM disease, autoimmune neurologic disease, and liver failure). Emphasis is placed on the practical challenges unique to children: vascular access and circuit sizing, blood priming for small patients, choice of replacement fluid (albumin vs. fresh frozen plasma), anticoagulation with citrate versus heparin, and the recognition and management of complications such as hypocalcemia, coagulopathy, and hemodynamic instability. Through short clinical cases, participants will practice prescribing and troubleshooting TPE at the bedside. By the end of this station, participants will be able to: 1. Explain the pharmacokinetic basis of TPE and justify the prescribed exchange volume and frequency. 2. Select appropriate ASFA-supported indications for TPE in pediatric AKI/critical-care settings and distinguish TPE from CRRT modalities. 3. Prescribe TPE for a child—vascular access, replacement fluid, anticoagulation—and adjust for body size. 4. Recognize and manage common complications (hypocalcemia, coagulopathy, hypotension, reactions).