I am seeing a 13 yr old pt with ESRD from hyperoxaluria who has mild iron overload from transfusions before coming to Canada. Currently seems not to need PRBC. LIC about 7. Is being assessed for combined liver/renal tx. On hemodialysis 6 days a week. My initial suggestion for iron chelation was use IV desferal but our local nephro team is adamant the HD line cannot be used for anything else? I am reticent to start on SC DFO due to logistical issue – family new to Canada etc but it could be doable. I did find some reports of EXJADE in patient on dialysis with starting doses of 10-15 mg/kg and appears to be doable. The kidneys are NOT expected to recover. I am hesitant to use deferiprone as the pt does have some marrow suppression so worsening neutrophil count.
Would appreciate any hearing about any ones’ suggestion of use of exjade or jadenu in such a pt. Or Alternately any other suggestions/thoughts.