Use of the Seraph® 100 Microbind® Affinity Blood Filter in an adolescent patient with disseminated adenoviral disease

The Seraph® 100 Microbind® Affinity Blood Filter (Seraph® 100) is an adjunctive pathogen adsorption device with emergency use authorization for use with extracorporeal therapies to treat COVID-19 infection. Here, we describe the use of Seraph® 100 in a 17-year-old chronically immunosuppressed patient status post deceased donor kidney transplant who presented initially for hematuria, dysuria, and fevers, and was found to have disseminated adenovirus (ADV) infection complicated by nephritis, viral pneumonia, elevated transaminases, and bone marrow suppression. Despite halting immunosuppression for 2 weeks, she remained febrile to 40.2 °C, with serum ADV counts > 10 million copies/mL (> log 7). Due to concerns about nephrotoxicity from cidofovir treatment, she underwent 2 intermittent treatments with Seraph® 100 to reduce viral load. Fever curve, blood counts, and transaminases stabilized in the days following treatment, and the patient was able to resume her prior immunosuppression regimen without a rebound in viral counts. This adolescent kidney transplant patient with disseminated ADV infection tolerated in-line treatment with Seraph® 100 without major clinical adverse events related to the adsorber, and had resolution of her ADV infection and good clinical recovery.