Abstract
ABSTRACT
To characterize pediatric TPE utilization, safety, treatment response, and mortality across American Society for Apheresis (ASFA) categories and over time. Retrospective single‐center cohort study of patients aged 0–25 years who underwent therapeutic plasma exchange (TPE) between 2011 and 2024. Primary outcomes included TPE utilization, temporal trends, and procedure‐related complications. Secondary outcomes included treatment response according to indication‐specific criteria and 28‐day mortality overall and by ASFA category. A total of 416 TPE courses were performed in 384 patients (median age 10 years, IQR 2–16). TPE utilization increased over time (Spearman
ρ
= 0.88;
p
p
p
= 0.11). Overall, 28‐day mortality was 13%, including 4% in Category I, 6% in Category II, and 24% in Category III (
p
p
= 0.02). TPE use in our single center has expanded substantially, particularly for lower‐evidence indications. Despite this shift, TPE remains safe and is associated with similar response rates across categories. Improved adjusted survival over time was observed in Category III.