aspheresis_services.php
 
Apheresis Services

We offer the latest, evidence-based apheresis techniques and technology. We provide clinical apheresis services for patients and stem cell donor. Clinical apheresis is carried out using a cell separator, which separates blood into its various components - red cells, white cells, platelets and plasma. The cell separator is programmed to collect only the component required for treatment. This specialist service is used for:

Do you want to become an Apheresis Donor?

What is an Apheresis?

Apheresis (a-fur-ee-sis) means "to take away". It is a special kind of donation that allows a donor to give specific blood components, such as platelets. During the apheresis procedure, all but the needed blood components are returned to the donor.


Why is blood separated?

Depending on their illness or injury, patients need different types of blood components. Whole blood is made up of several components: Red and white blood cells, plasma, and platelets. A cell separator called a centrifuge is used to separate the platelets from the remainder of the blood components.


What are platelets?

Platelets are blood cells that help control bleeding. When a blood vessel is damaged, platelets collect at the site of injury and temporarily repair the tear. They then activate substances in plasma which form a clot and allow the wound to heal.


Why are plateletpheresis donors needed?

After you donate whole blood, the unit is separated into platelets, red cells and plasma in our laboratory. Six to ten whole blood donations must be separated and pooled to provide a single platelet transfusion. However, one apheresis donation provides enough platelets for a complete transfusion.


Who needs platelets?

Many lifesaving medical treatments require platelet transfusions. Cancer patients, those receiving organ or bone marrow transplants, victims of traumatic injuries and many other patients require platelet transfusions to survive.


Who can be an apheresis donor?

Frequently, if you can donate whole blood, you can give platelets. Requirements for apheresis donation are very similar to those for whole blood donors.


  • At least18 year of age
  • In good health
  • Weight at least 55 kg
  • Not have taken aspirin or products containing aspirin within 72 hours prior to donation.

Are apheresis donations safe?

YES. Each donation is closely supervised throughout the collection by trained staff. A small percentage of your platelets are collected, so there is no risk to you of any bleeding problems. Your body will replace the donated platelets within 72 hours. The donation equipment (needles, tubing, and collection bags) is sterile and discarded after every donation, making it virtually impossible to contract any illness from the process.


How does the procedure work?

Blood is drawn from your arm through sterile tubing into a centrifuge. The centrifuge spins the blood to separate the components, which vary in weight and density. The platelets are drawn up into a collection bag, while the remaining blood components are returned to you through your other arm.


How long does it take?

Depending on your weight and height, the apheresis donation process will take approximately two hours. You may watch television or videotapes, listen to music, or simply sit back and relax while helping to save a life.


How do I become an apheresis donor?

Now that you know how important apheresis donors are, call the right hospitals blood bank at contact no


How do I become an apheresis donor?

Now that you know how important apheresis donors are, call the right hospitals blood bank at contact no


Therapeutic apheresis: Therapeutic apheresis includes plasma exchange and cytapheresis, which are generally tolerated by healthy donors. However, many minor and a few major risks exist. Insertion of the large IV catheters necessary for apheresis can cause complications (eg, bleeding, infection, pneumothorax). Citrate anticoagulant may decrease serum ionized Ca. Replacement of plasma with a noncolloidal solution (eg, saline) shifts fluid from the intravascular space. Colloidal replacement solutions do not replace IgG and coagulation factors.
Most complications can be managed with close attention to the patient and manipulation of the procedure, but some severe reactions and a few deaths have occurred.


Plasma exchange: Therapeutic plasma exchange removes plasma components from blood. A blood cell separator extracts the patient's plasma and returns RBCs and platelets in plasma or a plasma-replacing fluid; for this purpose, 5% albumin is preferred to fresh frozen plasma (except for patients with thrombotic thrombocytopenic purpura) because it causes fewer reactions and transmits no infections. Therapeutic plasma exchange resembles dialysis but, in addition, can remove protein-bound toxic substances. A one-volume exchange removes about 66% of such components.

To be of benefit, plasma exchange should be used for diseases in which the plasma contains a known pathogenic substance, and plasma exchange should remove this substance more rapidly than the body produces it. For example, in rapidly progressive autoimmune disorders, plasma exchange may be used to remove existing harmful plasma components (eg, cryoglobulins, antiglomerular basement membrane antibodies) while immunosuppressive or cytotoxic drugs suppress their future production.

The frequency of plasma exchange, the volume to be removed, the replacement fluid, and other variables are individualized. Low density lipoprotein cholesterol can be removed by plasma exchange with a recently implemented filtration method..

Indications for Plasma Exchange According to the American Society for Apheresis 

Category

Plasma Exchange

Cytapheresis

 

I. Accepted as 1st-line therapy, either alone or with other treatment

ANCA-mediated rapidly progressive
glomerulonephritis (Wegener's
granulomatosis), on dialysis or
with diffuse alveolar hemorrhage
Antiglomerular basement
membrane antibody disease (Goodpasture's syndrome), on
dialysis or with diffuse alveolar hemorrhage
Chronic inflammatory demyelinating polyradiculoneuropathy
Cryoglobulinemia, severe
Focal, segmental
glomerulosclerosis, recurrent
Guillain-Barre syndrome
Hemolytic-uremic syndrome,
atypical due to autoantibody to
factor H
Hyperviscosity in monoclonal
gammopathies
Myasthenia gravis
PANDAS (pediatric autoimmune
neuropsychiatric disorders
associated with streptococcal
infections)
Paraproteinemic polyneuropathy with IgG/IgA, IgM (with or without Waldenström's macroglobulinemia)
Renal transplantation, antibody
-mediated rejection
Sydenham's chorea
Thrombotic thrombocytopenia
purpura
Wilson's disease, fulminant
Babesiosis, severe: RBC exchange
Cutaneous T-cell lymphoma, erythrodermic: Photopheresis
Familial hypercholesterolemia (homozygotes): Lipid absorption
Heart transplant rejection (prophylaxis): Photopheresis
Hyperleukocytosis with leukostasis syndrome: Leukodepletion
Sickle cell disease with acute stroke: RBC exchange

II. Accepted as 2nd-line therapy, either alone or with other treatment

ABO incompatible stem cell or kidney transplant (recipient)
Anemia, pure red cell aplasia
Antiphospholipid syndrome, catastrophic
Autoimmune hemolytic anemia, cold agglutinin disease (life threatening)
Hemolytic-uremic syndrome, due to complement factor gene mutation
Lambert-Eaton syndrome
Multiple sclerosis, acute, unresponsive to corticosteroids
Myeloma (cast nephropathy)
Neuromyelitis optica
Phytanic acid storage disease (Refsum's disease)
Rasmussen's encephalitis
Red cell alloimmunization in pregnancy (before intrauterine transfusion available)
Renal transplantation,
desensitization (living donor, due
to donor-specific HLA antibody)

SLE if severe (eg, cerebritis, diffuse alveolar hemorrhage)

Cryoglobulinemia due to hepatitis C: Immuneadsorption
Familial hypercholesterolemia (heterozygotes): Lipid absorption
Graft vs host disease, skin: Photopheresis
Heart or lung transplant rejection (treatment): Photopheresis
Inflammatory bowel disease: Adsorptive cytapheresis
Malaria, severe: RBC exchange
Rheumatoid arthritis, refractory: Immuneadsorption
Sickle cell disease with acute chest syndrome: RBC exchange
Thrombocytosis, symptomatic: Platelet depletion
III. Optimal role of apheresis is not established; decision should be individualized (IRB approval desirable)
Acute hepatic failure
Aplastic anemia
Autoimmune hemolytic anemia,
warm
Cardiomyopathy, dilated (New York Heart Association class II to IV)
Heart transplant rejection (antibody mediated)
Hemochromatosis, hereditary
Multiple myeloma with
polyneuropathy
Multiple sclerosis (progressive)
Paraneoplastic neurologic
syndromes
Posttransfusion purpura
Coagulation factor inhibitors: Immuneadsorption
Cutaneous T-cell lymphoma, non-erythrodermic: Leukodepletion
Graft vs host disease, non-skin: Photopheresis
Pemphigus vulgaris: Photophoresis
Polycythemia vera or erythrocytosis: RBC depletion
IV. Published evidence demonstrates or suggests apheresis ineffective or harmful.
Amyloidosis, systemic
Burn shock resuscitation
Coagulation factor inhibitors
Dermatomyositis or polymyositis
Hemolytic-uremic syndrome, typical or diarrhea associated
Immune thrombocytopenic purpura
Inclusion-body myositis
Pemphigus vulgaris
Psoriasis
Rheumatoid arthritis
Dermatomyositis or polymyositis: Leukapheresis
Inclusion-body myositis: Leukapheresis
ANCA = antineutrophil cytoplasmic antibody; IRB = institutional review board.

Cytapheresis:
Therapeutic cytapheresis removes cellular components from blood,returning plasma. It is most often used to remove defective RBCs and substitute normal ones in patients with sickle cell anemia who have the following conditions: acute chest syndrome, stroke, pregnancy, or frequent, severe sickle cell crises. Cytapheresis achieves Hb S levels of < 30% without the risk of increased viscosity that can occur because of increased Hct with simple transfusion.
Therapeutic cytapheresis may also be used to reduce severe thrombocytosis or leukocytosis (cytoreduction) in acute or chronic leukemia when there is risk of hemorrhage, thrombosis, or pulmonary or cerebral complications of extreme leukocytosis (leukostasis). Cytapheresis is effective in thrombocytosis because platelets are not replaced as rapidly as WBCs. One or 2 procedures may reduce platelet counts to safe levels. Therapeutic WBC removal (leukapheresis) can remove kilograms of buffy coat in a few procedures, and it often relieves leukostasis and splenomegaly. However, the reduction in WBC count itself may be mild and only temporary.
Other uses of cytapheresis include collection of peripheral blood stem cells for autologous or allogeneic bone marrow reconstitution (an alternative to bone marrow transplantation) and collection of lymphocytes for use in immune modulation cancer therapy (adoptive immunotherapy)
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