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Therapeutic Apheresis

Southern Blood Services Region       

What is therapeutic apheresis?

Blood is a complex fluid whose components are red cells, white cells, cell fragments called platelets and a liquid called plasma. Therapeutic apheresis is a medical treatment during which blood is collected from a patient and separated into its components. One of the components is then removed and discarded because it is abnormal in some way. The remainder of the blood is returned to the patient, together with a replacement fluid to make up in volume for the amount discarded.

 

What fluid is used to replace the blood component that is removed?

Salt solutions, albumin (a protein constituent of plasma), as well as plasma itself obtained from American Red Cross volunteer blood donors, are the replacement fluids used most often.

 

How is the blood separated?

The separation takes place in a machine called a blood processor. A catheter is placed in a vein in the patient’s arm, neck, chest or leg and blood is allowed to flow through tubing from the patient to the machine. (The catheter and tubing are sterile, used only once and disposed.) There is a centrifuge in the machine that accomplishes the actual separation of the blood into its components. If a patient is scheduled for a series of treatments, the catheter may remain where it is first inserted until the entire series of treatments is completed.

 

How long does the treatment take?

It depends on the patient’s condition, weight and tolerance. Usually, though, one session takes two and a half to three hours. Several sessions may be required to achieve the medical goal.

 

Who performs the treatments?

All personnel come from your local Red Cross and are supervised by a Red Cross physician, registered nurse or hemapheresis practitioner. A Red Cross staff person is always present throughout the procedure. Your local hospital staff provides supportive care during the procedure. The nurses who perform the procedures are specially trained in therapeutic apheresis techniques. All equipment used is supplied by your hospital or local Red Cross.

 

Is hospitalization necessary?

Therapeutic apheresis is almost always performed in a hospital setting. It can be done on an outpatient basis if the patient’s condition permits.

 

Is therapeutic apheresis painful?

Insertion of the catheter into a vein for drawing blood during the procedure may be uncomfortable. Stiffness may occur from lying down for the duration of the treatment.

 

Are there any complications?

Some complications may result because of your medical condition, or they may result from the procedure itself. You may experience chills, tingling, a slight drop in blood pressure or feelings of tiredness or anxiety. Please communicate any of these symptoms to the nurse. Serious complications are rare. Your physician will review the risks of and expected benefits from therapeutic apheresis when he or she first discusses this treatment with you.

 

Can I get AIDS or hepatitis from the replacement fluid?

Salt solutions are sterile and cannot transmit infections. All the donated blood used to obtain albumin and plasma, which might be used as replacement fluids in therapeutic apheresis, is screened and tested for AIDS and hepatitis. In addition, all of the albumin and some types of plasma are specially treated to kill or inactivate these viruses. But the possibility of acquiring viral or other infections remains with other types of plasma. The risk today is extremely small. For example, the chances of a hospital patient being infected with HIV from transfusion are less than one in a million.

 

Must I take special precautions after the treatment?

A rest period is recommended. Avoid lifting heavy objects if possible. Follow any other special instructions your doctor may give.

 

How often will I need therapeutic apheresis?

The frequency of treatment depends on your medical condition, and on your physician’s recommendations.

 

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