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    Apheresis: (Principle & Clinical Applications)

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    aprinal
    This document discusses apheresis, which involves removing or manipulating specific components of blood. Apheresis procedures are used to collect blood components from donors or remove unwanted components from patients. Key procedures include plateletpheresis to collect platelets, and plasmapheresis to collect plasma. Automated cell separator machines use centrifugation or filtration to separate blood based on properties like specific gravity and size. Apheresis is used clinically to obtain blood products for transfusion or to therapeutically remove components from patients.

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    Apheresis: (Principle & Clinical Applications)

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    aprinal
    157 views35 pages
    This document discusses apheresis, which involves removing or manipulating specific components of blood. Apheresis procedures are used to collect blood components from donors or remove unwanted components from patients. Key procedures include plateletpheresis to collect platelets, and plasmapheresis to collect plasma. Automated cell separator machines use centrifugation or filtration to separate blood based on properties like specific gravity and size. Apheresis is used clinically to obtain blood products for transfusion or to therapeutically remove components from patients.

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    This document discusses apheresis, which involves removing or manipulating specific components of blood. Apheresis procedures are used to collect blood components from donors or remove unwanted components from patients. Key procedures include plateletpheresis to collect platelets, and plasmapheresis to collect plasma. Automated cell separator machines use centrifugation or filtration to separate blood based on properties like specific gravity and size. Apheresis is used clinically to obtain blood products for transfusion or to therapeutically remove components from patients.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    157 views35 pages

    Apheresis: (Principle & Clinical Applications)

    Uploaded by

    aprinal
    This document discusses apheresis, which involves removing or manipulating specific components of blood. Apheresis procedures are used to collect blood components from donors or remove unwanted components from patients. Key procedures include plateletpheresis to collect platelets, and plasmapheresis to collect plasma. Automated cell separator machines use centrifugation or filtration to separate blood based on properties like specific gravity and size. Apheresis is used clinically to obtain blood products for transfusion or to therapeutically remove components from patients.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 35

    APHERESIS

    (Principle & Clinical Applications)

    Teguh Triyono
    Bagian Patologi Klinik/ UPTD
    FK UGM/ RSUP Dr Sardjito
    Apheresis
     Derived from Greek word “Phaeresis” which means
    “taking away”

     Apheresis constitutes a number of procedures in which


    donor/patient blood is processed to remove or
    manipulate a specific portion of blood.

     The remaining blood is returned back to the


    donor/patient
     A prefix added to the term
    ‘Apheresis’ indicates what is
    being removed, such as
    – Plateletpheresis (Platelets)
    – Leukapheresis (Leukocytes)
    – Stemcellapheresis
    – Lymphocytapheresis
    – Monocytapheresis
    – Granulocytapheresis
    – erythrocytapheresis
    – Plasmapheresis (Plasma)
    Principle apheresis

    • Filtration techniques

    • Centrifuge techniques

    • Combinations

    4
    Separation by gradients

    Specific weight
    5
    Blood
    Plasma

    Trombocytes

    Leukocytes

    Erytrocytes

    6
    Separation in the system

    Plasma

    Trombocytes
    Lymphocytes
    Monocytes
    } Granulocytes

    Erytrocytes

    7
    Centrifuge channel

    8
    Centrifuge channel and ‘RPM’

    PHTDI, April 2013 9


    10
    Cell selection

    11
    Methods of Apheresis :
     Conventional/ manual

     Automatic/ Cell Separator Machines

    - Intermittent flow separation


    - Continuous flow separation
    Automated Separation
     Centrifugation : depend on specific
    gravities of the components
     Filtration : Pore size
    Separation based on specific weight / size
    Spec Weight (g/mL) Size (µm
    • Plasma 1.026
    • Platelets 1.040 1-4
    • Lymphocytes 1.050-1.061 6-10
    • Monocytes 1.077 10-30
    • Granulocytes 1.080 -1.088 10-15
    • Erytrocytes 1.093-1.100 6-8
    Apheresis equipment

    15
    Apheresis procedures

    • Donors • To collect components

    • To collect components
    • Patients
    • To remove components
    • To exchange
    components

    Therapeutic Apheresis
    16
    Donor Apheresis

    • Plasmapheresis

    • Cytaferese
    - Trombocytapheresis
    - Lymphocytapheresis Cell therapy

    - Stamcelapheresis
    - Monocytapheresis
    - Granulocytapheresis
    - Erytrocytapheresis 17
    Plateletpheresis
     Plateletpheresis : collection of platelets
    from a donor with return of donor RBCs

     Plateletpheresis is the most common


    application of apheresis
     2 types of platelet components :
    - random donor platelets or whole
    blood derived platelets
    - single donor platelets or apheresis
    platelets
    PLATELETS
    Pooled Platelets

    Life span 5 days


    Stored at room temperature
    Lose function when refrigerated or
    transfused into cold patient.
    One platelet concentrate : 0.5 x 10e 11
    suspended in 50 ml plasma.
    pH > 6.5 after 72 hours storage at 22°C
    Plateletpheresis (Single Donor Platelet )

    2 to 5 x 10e11 platelet yield


    30% drop in donor platelet count
    replaced in 48 hours
    Low white cell contamination
    Minimal donor red cell loss
    Fewer donor reactions than whole
    blood donations.
    Pheresis Platelets
    o o
    Storage: at 20 C to 24 C under
    constant agitation. Maximum
    storage time = 5 days

    Therapeutic dose: between 2.0 – 5.0 x 1011


    Platelets = 4-8 whole blood collections.
    Pheresis Donation Vs Whole Blood Donation
    Pheresis Donation Whole Blood Donation
    Blood Cell Separator No specialized equipment
    Ave 1.5 to 2 hours 10 mins
    No shows, rejections, More uniform work flow
    deferrals very costly
    Hospital/blood center Mobile collection
    By appointment Walk-ins
    Lab & medical access Autonomous operation
    Risk of blood transfusion
    Viral infection Frequency per No. of deaths per
    million units millions u.

    Hepatitis A 1 0
    Hepatitis B 7-32 0-0.14
    Hepatitis C 4-36 0.5-17
    HIV 0.4-5 0.5-5
    HTLV (I/II) 0.5-4 0
    Parvovirus B19 100 0
    Risk of blood transfusion
    Other Risk Factor Frequency per No. of deaths per
    million units millions u.
    Bacterial 2 0.1-0.25
    contamination (Rbc)
    Bacterial contam. 83 21
    (Platelet)
    Acute hemolytic 1-4 0.67
    reactions
    Delayed hemolytic 1000 0.4
    reactions
    Trali 200 0.2
    Risks of Platelet Transfusion
    Contamination of Platelets
    The risk of platelet sepsis is greater
    with a transfusion of pooled platelet
    concentrates from multiple donors
    than from a single donor.
    Risks of Platelet Transfusion
    Platelet transfusion can transmit viral or
    bacterial disease.
    Contaminating red cells in the product may
    transmit malaria.
    Graft-versus-host disease (preventable by
    irradiation)
    Cytomegalovirus (preventable by serological
    screening)
    Alloimmunization caused by contaminating
    white cells.
    Risk of Platelet transfusion

    Leukocyte removed could possibly prevent all


    these problems, but this is not established.
    Febrile reactions are common and are reduced
    but not totally eliminated by Leukocyte
    removal
    Platelet themselves may cause fever.
    Advantages of Single Donor Platelets Over Pooled
    Platelet Concentrate Transfusions

    One donor exposure only


    For special feature collections (HLA-
    matched, CMV-negative)
    Lower reaction rate
    Lower risk of alloimmunization and
    transmission of viruses
    Increased donor productivity
    Advantages of Single Donor Platelets Over Pooled
    Platelet Concentrate Transfusions

    One Pretransfusion Test


    Lower Cost than Manual Collection
    Prompt Transfusion Possible
    Less Unit Handling
    Compliance with Quality System
    Standards
    Patient Apheresis (reduction of cells)

    • Cytaferese
    - Trombocytes
    - Lymphoblasts
    - Myeloblasts
    - Erytrocytes

    33
    Patient Apheresis (exchange)

    • Plasma exchange

    • RBC exchange

    34
    Terimakasih

    PHTDI, April 2013

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