Therapeutic Apheresis

Apheresis is the process of removing whole blood from a patient or donor and separating the blood into its components (plasma, white blood cells, platelets, and red blood cells). This is typically accomplished using a centrifuge device that spins the whole blood so that it separates. Once separated, the desired component is then removed, and the rest of the whole blood is reinfused back into the patient or donor. The most commonly known apheresis procedure is plasma or platelet donation, where parts of the blood are collected from a healthy donor and used for patients requiring transfusions in the hospital.

Therapeutic apheresis is performed on patients with a variety of medical disorders. It may be prescribed to remove harmful substances or cells in the blood which contribute to these disorders. In the list below you will find the most common diagnoses where therapeutic apheresis treatment is used.

• Thrombotic Thrombocytopenic Purpura (TTP)
• Guillain-Barre Syndrome (GBS)
• Myasthenia gravis
• Autoimmune polyneuropathies
• Waldenstrom’s macroglobulinemia
• Goodpasture’s syndrome
• Rapidly progressive glomerulonephritis
• Cryoglobulinemia
• Sickle cell disease
• Pulmonary renal syndrome

There are several types of apheresis therapies and many have become a common treatment modalities.

• Therapeutic plasma exchange: The removal of plasma from the blood, which may require replacement with another donor plasma or albumin
• Leukocytapheresis: The removal of white blood cells
• Thrombocytapheresis: The removal of platelets
• Red blood cell exchange: The removal of red blood cells which are “exchanged” or replaced by donor red blood cells
• LDL apheresis: The removal of LDL cholesterol from the blood
• Peripheral stem cell collection: The collection of stems cells from the blood stream versus bone marrow for reinfusion, clinical research, or personalized vaccines
• Photopheresis: The removal of a patient's white blood cells which are treated with a photosensitizing agent and ultraviolet light, then reinfused back into the patient

Therapeutic apheresis procedures can be performed in both the hospital (inpatient) and outpatient setting, depending on the condition. Blood tests are usually performed prior to the procedure, with the therapy itself taking anywhere from 2-4 hours. Your healthcare team will prepare you for what to expect from the therapeutic apheresis treatment when it is prescribed.