Conservative blood priming for extracorporeal photopheresis to reduce allogenic blood exposure in pediatric patients - 12/03/25

Doi : 10.1016/j.tracli.2025.02.009

Andriana Pavlovich ^a, Paxton Barco ^a, Brian Cook ^a, Ashley Peck ^a, Faith Matthews ^a, Yembur Ahmad ^a,^b, Craig Fletcher ^a,^b, Yamac Akgun ^a,^b,^⁎
^a Department of Pathology and Laboratory Medicine, Children’s Hospital Los Angeles, Los Angeles, CA, USA
^b Department of Pathology, Keck School of Medicine of USC, Los Angeles, CA, USA

^⁎Corresponding author at: Department of Pathology and Laboratory Medicine, Children’s Hospital Los Angeles, Los Angeles, CA, USA.Department of Pathology and Laboratory MedicineChildren’s Hospital Los AngelesLos AngelesCAUSA

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 12 March 2025

Highlights

•	Extracorporeal Photopheresis.
•	Prime.
•	Red Cell Transfusion.
•	Pediatric Transfusion.

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Abstract

Extracorporeal photopheresis (ECP) is a vital therapeutic option for pediatric patients with immune-mediated conditions. However, the high extracorporeal volume (ECV) involved in ECP poses a risk of hypovolemia, often necessitating red blood cell (RBC) priming to maintain hemodynamic stability. This study evaluates a conservative approach to ECP without RBC priming in pediatric patients, aiming to reduce allogenic blood exposure. A retrospective review of 16 ECP procedures across 3 pediatric patients with ECV exceeding 15% of total blood volume (TBV) found no significant adverse events or hemodynamic instability. The absence of RBC priming did not result in any documented complications. These findings suggest that conservative blood priming can safely reduce allogenic blood exposure in pediatric ECP, potentially minimizing transfusion-related risks. Further research is needed to establish guidelines for patient selection and monitoring during non-prime ECP in pediatric populations.

Le texte complet de cet article est disponible en PDF.

Keywords : Extracorporeal Photopheresis, Prime, Red Cell Transfusion, Pediatric Transfusion