Satyam Arora: Pediatric Apheresis – When Every Millilitre Matters
Satyam Arora, Regional Director for South East Asia at the International Society of Blood Transfusion, shared a post on LinkedIn:
“Pediatric Apheresis: When Every Millilitre Matters
A technically demanding day at the Department of Transfusion Medicine, PGICH Noida, with two specialized pediatric apheresis procedures running simultaneously, both in children weighing <20 kg:
Therapeutic apheresis for a child with atypical hemolytic uremic syndrome (aHUS)
Allogenic Peripheral blood stem cell (PBSC) collection in another child
Low-weight pediatric patients present a unique challenge during apheresis.
For both procedures, red cell priming of the extracorporeal circuit was therefore required to minimise the physiological impact of initiating extracorporeal circulation.
Successful pediatric apheresis requires careful consideration of total blood volume, extracorporeal volume, hematocrit, vascular access, anticoagulation, calcium balance, fluid balance and continuous hemodynamic monitoring.
These are not simply ‘smaller versions’ of adult procedures—the physiology, technical constraints and margins of safety are fundamentally different.
At PGICH Noida, we are seeing a growing number and diversity of these complex pediatric procedures, reinforcing the need for dedicated pediatric apheresis expertise, appropriately trained teams, standardized protocols and close multidisciplinary collaboration.
In pediatric apheresis, every millilitre matters—and so does every decision.”
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