Publication Date
10-23-2025
Journal
Blood Purification
DOI
10.1159/000549111
PMID
41129413
PMCID
PMC12668435
PubMedCentral® Posted Date
12-2-2025
PubMedCentral® Full Text Version
Author MSS
Abstract
Introduction: The selective cytopheretic device (SCD) is a cell-directed extracorporeal therapy approved for use in children with acute kidney injury (AKI) receiving continuous renal replacement therapy (CRRT) with sepsis/sepsis-like conditions. We compared outcomes for children treated with SCD to a contemporary cohort of children treated with CRRT alone.
Methods: Secondary analysis and comparison of patients ≤22 years old and ≥10 kg from a multicenter registry of patients receiving CRRT for AKI and/or fluid overload (WE-ROCK; 2015-2021) to patients from two multicenter, prospective, interventional studies of children with AKI and multiple organ dysfunction (MODS) receiving SCD (SCD-PED-01/SCD-PED-02; 2016-2022).
Results: Eighteen patients in the SCD cohort were compared to 178 in the CRRT cohort. There were no differences between cohorts at CRRT ± SCD initiation. SCD patients had shorter CRRT duration (6 [3, 11] vs. 10 [5, 18] days, p = 0.013) and shorter ICU length of stay (LOS) in survivors (16 [11, 25] vs. 27 [16, 46] days, p = 0.012). Survival to ICU discharge or day 60 was 94% in the SCD cohort vs. 74% in the CRRT cohort (p = 0.079). A Bayesian analysis demonstrated a >99% probability of improved survival with SCD. A sub-analysis in septic patients demonstrated greater survival (100% vs. 69%, p = 0.032), shorter CRRT duration (5 [3, 7] vs. 11 [6, 17] days, p = 0.006) and reduced ICU LOS in survivors (21 [10, 25] vs. 27 [16, 45] days, p = 0.027) in SCD-treated patients.
Conclusions: The addition of SCD therapy in children with AKI and MODS receiving CRRT may be beneficial, though larger prospective studies are needed.
Keywords
acute kidney injury, continuous renal replacement therapy, pediatrics, mortality, sepsis
Published Open-Access
yes
Recommended Citation
Stanski, Natalja L; Seo, JangDong; Jenkins, Todd; et al., "Use of the Selective Cytopheretic Device with Continuous Renal Replacement Therapy in Children: A Comparison of Contemporary Cohorts" (2025). Faculty and Staff Publications. 5738.
https://digitalcommons.library.tmc.edu/baylor_docs/5738