How Low Can You Go? Defining Safe Lower-weight Boundaries for Pediatric Apheresis

Proposed Session Description: Lower weight limits in pediatric patients continue to challenge both therapeutic apheresis and cellular collections, particularly as clinical demand expands and indications evolve. This session will explore the evidence supporting safe procedures for patients weighing less than 25 kg, with an emphasis on risk stratification rather than a single absolute cutoff.
Key topics will include managing low circulating blood volumes, indications for and risks of red cell priming, vascular access strategies, alternative anticoagulation, circuit size limitations, and mitigation of adverse events such as hypocalcemia and hemodynamic instability. This forum will also review equipment and platform considerations, including circuit alternatives and manual versus automated exchange strategies when standard configurations are not feasible.
Through case-based discussion and panel debate, experienced pediatric apheresis practitioners will highlight areas of practice variability, unresolved controversy, and practical safeguards that support safe, defensible decision-making. The session is designed for physicians, nurses, laboratory leadership, and quality and safety professionals involved in pediatric apheresis program oversight.