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    APHERESIS

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    Marie Millicent Manlimos
    Apheresis is a medical technology that involves separating out specific components of blood through centrifugation or filtration. Blood is drawn from the donor or patient and separated into its components, with the desired component collected and the remaining components returned. It is commonly used to collect platelets, plasma, leukocytes, and red blood cells. Apheresis has both collection and therapeutic applications, and can be used to treat various conditions by removing pathogenic substances from the blood. Potential adverse effects include vascular access complications, allergic reactions, and hypovolemia. Proper training of staff and quality control standards are important to ensure safety.

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    APHERESIS

    Uploaded by

    Marie Millicent Manlimos
    154 views3 pages
    Apheresis is a medical technology that involves separating out specific components of blood through centrifugation or filtration. Blood is drawn from the donor or patient and separated into its components, with the desired component collected and the remaining components returned. It is commonly used to collect platelets, plasma, leukocytes, and red blood cells. Apheresis has both collection and therapeutic applications, and can be used to treat various conditions by removing pathogenic substances from the blood. Potential adverse effects include vascular access complications, allergic reactions, and hypovolemia. Proper training of staff and quality control standards are important to ensure safety.

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    Apheresis is a medical technology that involves separating out specific components of blood through centrifugation or filtration. Blood is drawn from the donor or patient and separated into its components, with the desired component collected and the remaining components returned. It is commonly used to collect platelets, plasma, leukocytes, and red blood cells. Apheresis has both collection and therapeutic applications, and can be used to treat various conditions by removing pathogenic substances from the blood. Potential adverse effects include vascular access complications, allergic reactions, and hypovolemia. Proper training of staff and quality control standards are important to ensure safety.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC or read online from Scribd
    Download as doc
    154 views3 pages

    APHERESIS

    Uploaded by

    Marie Millicent Manlimos
    Apheresis is a medical technology that involves separating out specific components of blood through centrifugation or filtration. Blood is drawn from the donor or patient and separated into its components, with the desired component collected and the remaining components returned. It is commonly used to collect platelets, plasma, leukocytes, and red blood cells. Apheresis has both collection and therapeutic applications, and can be used to treat various conditions by removing pathogenic substances from the blood. Potential adverse effects include vascular access complications, allergic reactions, and hypovolemia. Proper training of staff and quality control standards are important to ensure safety.

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    APHERESIS

    - also termed hemapheresis - Gk derivation w/c means to separate or remove - collects the specific/desired blood component and the remaining are given back to the donor - blood is withdrawn from a donor or patient and separated into its components; the remaining constituents are recombined and returned to the individual Anticoagulated blood: Plasma (water, proteins, other solutes) - 55% Buffy coat (WBC and platelets) - <1% RBC - 45% *Most commonly applied concept of separation in apheresis is centrifugation. *All apheresis collection uses anticoagulant. Centrifugation Variables: 1. speed and diameter 2. sit time (settlement time, dwell time) 3. solution added 4. cellular content or plasma volume - METHOD Procedures vary according to the particular component of the blood to be harvested and the equipment used. Time range (single procedure): 45-120 mins Uses disposable equipments such as sterile bags, tubing, and collection chambers unique to the machine. Platelets are collected in a closed system (5-day dating period) 2 categories of centrifugation method of separation: Intermittent flow centrifugation (IFC) and Continuous flow centrifugation (CFC) - EQUIPMENT .

    blood withdrawn centrifugation separation/processing desired components collected remaining components reinfused on the same venipuncture site One venipuncture only. Continuous Flow Centrifugation (CFC) withdraw, process, and return the blood to the individual simultaneously blood withdrawn centrifugation separation/processing desired components collected remaining components reinfused via 2nd venipuncture site Two venipuncture sites. Extracorporeal Volume volume of blood outside the body amount of blood out of the individual in the centrifuge bowl and tubing usually greater in IFC than in CFC Membrane Filtration Technology Blood that passes over membranes with specific pore sizes allows passage of plasma through the membrane while the cellular portion passes over it. Advantage: collection of cell-free product and the ability to selectively remove plasma components by varying pore sizes. - FLUIDS Acid Citrate Dextrose - most commonly used anticoagulant; 21 days Heparin - 2 to 5 days Normal Saline Solution - used 1to prime the system, 2to keep the line open, 3 to help maintain fluid volume Hydroxyethyl Starch (HES) sedimenting agent (for granulocyte collection); induces roleaux formation (better separation of WBCs and RBCs) Normal Serum Albumin - most commonly used replacement fluid

    Intermittent Flow Centrifugation (IFC) performed in cycles (passes)

    Fresh Frozen Plasma - optimal fluid replacement

    quality

    - GENERAL REQUIREMENTS Staff should be well-trained in: machine operation and quality control donor selection familiarity with the standards of AABB and documentation management of complication venous access - APPLICATIONS Collection of larger quantities of components from a single donor. Transfusion-transmitted diseases and alloimmunization - COMPONENT COLLECTION Plasmapheresis plasma is separated from the cellular components useful in collecting FFP in reference laboratories: used to collect rare RBC and WBC antibodies commercially: for manufacturing plasma derivatives, hepatitis immune globulin, and Rh-immune globulin Erythrocytapheresis separation of RBCs from whole blood RBC disease such as sickle cell crises or severe malaria are contraindicated Automation: Double Reds or Double Red Cell Apheresis If two units of RBCs are collected by apheresis, the donor must wait 16 weeks before providing another donation that includes RBCs. Plateletpheresis separation of platelets from whole blood indicated in patients who are bleeding or at an increased risk for bleeding secondary to thrombocytopenia or platelet dysfunction

    control demands: should contain a minimum of 3x1010 platelets, which is equivalent to 6-10 random platelet concentrates in 90% of units tested; pH 6.2 Leukapheresis removal of PMNs, basophils, eosinophils difficulty in collection, short shelf-life (24hrs, 20-24oC w/o agitation) HES is used to improve yield while minimizing RBC collected quality control: must contain a minimum of 1.0x1010 granulocytes in at least 75% of units tested irradiated (do not affect PMN function) ABO compatibility should be employed Cytapheresis collection of hematopoietic progenitor cells - THERAPEUTIC PROCEDURES Rationale: A pathogenic substance exists in the blood that contributes to a disease process or its symptoms The substance can be more effectively removed by apheresis than by the bodys own homeostatic mechanisms. Therapeutic Cytapheresis leukocytapheresis - WBC, leukemia (myeloid lineage) plateletpheresis - platelet count, myeloproliferative disorders such as polycyhtemia vera, platelets greater the ! M/uL may develop thrombotic or hemorrhagic complications lymphocytapheresis & lymphoplasmapheresis - means of producing immunosuppression in conditions with a cellular mechanism such as rheumatoid arthritis, systemic lupus eryhtematosus, kidney transplant rejection, and autoimmune and alloimmune diseases. erythrocytapheresis - an exchange procedure; treat various complications of sickle cell disease such as priapism, acute chest syndrome, and impending stroke

    lymphocyte

    TherepeuticPlasmapheresis(PlasmaExchange): Removes the offending agent in the plasma causing the clinical symptoms; larger volume must be replaced or exchanged Factors removed: immune complexes (systemic lupus erythematosus) autoantibodies or alloantibodies (factor VIII inhibitors) antibodies causing hyperviscosity (Waldenstrms macroglobulinemia) inflammatory mediators (fibrinogen and complement) antibody blocking the normal function of the immune system protein-bound toxins (barbiturate poisoning) lipoproteins platelet-aggregating factors Immunoadsorption a specific ligand is bound to an insoluble matrix in a column or filter Photopheresis requires a special intermittent flow machine utilizing bowl technology effective for graft vs host disease, cutaneous T-cell lymphoma treated with a drug psoralen collected WBCs are exposed to UV light which activates the drug and prevents replication - ADVERSE EFFECTS toxicity - most common vascular access complication (hematoma, sepsis, phlebitis, neuropathy) vasovagal reactions hypovolemia allergic reactions hemolysis air embolus depletion of clotting factors circulatory and respiratory distress transfusion-transmitted disesases
    citrate

    depletion

    loss of proteins and immunoglobulins

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