{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:39:28Z","timestamp":1792611568646,"version":"4.5.0"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Pediatric evidence for therapeutic plasma exchange (TPE) is largely small, single\u2010center cohorts; there is no prior large\u2010scale age\u2010stratified outcomes assessment. Using the TriNetX US Collaborative Network, we identified 3744 patients \u2264\u200917\u2009years old undergoing an index TPE procedure, stratified into four age groups (\u2264\u20091, 2\u20135, 6\u201312, and 13\u201317\u2009years). ICD\u201010\u2010CM diagnosis codes recorded 30\u2009days prior to the index procedure were mapped to American Society for Apheresis Categories I\u2013III indications; three high\u2010prevalence nonspecific codes were tracked separately. All\u2010cause mortality at 30\u2009days, 90\u2009days, and 1\u2009year was assessed. All\u2010cause mortality decreased with increasing age at every time window: 30\u2010day mortality ranged from 16.8% (\u2264\u20091\u2009year) to 4.3% (13\u201317\u2009years,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001). Infant mortality risk was concentrated disproportionately in the first 90\u2009days postprocedure. Sex distribution shifted from a slight male predominance in infancy and early childhood (55%\u201356% male) to a female predominance in adolescence (55% female,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001). Leading specific indications were autoimmune encephalitis (10%), sepsis with multiorgan failure (9%), renal transplant rejection (6%), acute disseminated encephalomyelitis (5%), Guillain\u2013Barr\u00e9 syndrome (5%), and myasthenia gravis (4%); nonspecific diagnosis codes were each individually more prevalent than any single ASFA\u2010mapped indication. This is the first large\u2010scale, age\u2010stratified, multi\u2010institutional characterization of pediatric TPE. We identified an inverse relationship between age and all\u2010cause mortality, a sex\u2010distribution shift in adolescence, and an indication landscape dominated by nonspecific diagnosis codes. These findings offer age\u2010stratified benchmarks for clinical counseling and hypothesis generation.\n                  <\/jats:p>","DOI":"10.1002\/jca.70198","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T04:07:06Z","timestamp":1792469226000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Therapeutic Plasma Exchange in Pediatric Patients: A Multi\u2010Institutional Landscape Analysis"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5474-1996","authenticated-orcid":false,"given":"Caitlin","family":"Raymond","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine University of Wisconsin\u2013Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2022.10.017"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.22043"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13760\u2010018\u20100961\u20105"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1744\u20109987.12173"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100040\u20101714098"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/1744\u20109987.13474"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2021.103181"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.4103\/jpcc.jpcc_81_23"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/aor.14559"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/1744\u20109987.70149"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.14744\/SEMB.2025.56750"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000641"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467\u2010020\u201004769\u2010z"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.70007"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.13925"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21242"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2025.1516126"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.34472"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2019.06.017"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/1750\u20101172\u20106\u201060"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir1038"}],"container-title":["Journal of Clinical Apheresis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.70198","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jca.70198","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.70198","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T18:56:17Z","timestamp":1792608977000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jca.70198"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":21,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/jca.70198"],"URL":"https:\/\/doi.org\/10.1002\/jca.70198","archive":["Portico"],"relation":{},"ISSN":["0733-2459","1098-1101"],"issn-type":[{"value":"0733-2459","type":"print"},{"value":"1098-1101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-07-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70198"}}