Supplementary Material for: Use of the Selective Cytopheretic Device with Continuous Renal Replacement Therapy in Children: A Comparison of Contemporary Cohorts

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.