Tandem hemodialysis and plasma exchange

The combination of hemodialysis and plasma exchange as one tandem procedure was first described in 1999 by Siami et al. (ASAIO J 45:229-233), but larger pediatric case series were not described until 2012. Even in adults, there are only limited case series. If performed in sequence, up to 8 h of treatment time may be required. With the use of the tandem procedure in stable patients, the same procedures can be completed during the same time as a routine hemodialysis, which is more convenient for patients and may reduce healthcare costs. Little is known about the utilization of the combination of hemodialysis and plasma exchange in children. The purpose of this review is to summarize the adult and scarce pediatric experience. The results of a survey carried out by the authors using the Internet listserver 'PedNeph' to obtain an overview of the current practice patterns of pediatric nephrologists are also presented. Keywords Tandem procedure * Plasma exchange * Hemodialysis * Plasmapheresis * Atypical hemolytic uremic syndrome * Antibody-mediated rejection
Introduction Hemodialysis (HD) is indicated for severe acute and chronic kidney failure. It removes uremic toxins by allowing the equilibration of these toxins between plasma water and dialysate across a [...]