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Ethan Gonzalez
Ethan Gonzalez

Apheresis


The American Society for Apheresis (ASFA) Journal of Clinical Apheresis (JCA) Special Issue Writing Committee is charged with reviewing, updating and categorizing indications for the evidence-based use of therapeutic apheresis (TA) in human disease. Since the 2007 JCA Special Issue (Fourth Edition), the committee has incorporated systematic review and evidence-based approaches in the grading and categorization of apheresis indications. This Eighth Edition of the JCA Special Issue continues to maintain this methodology and rigor in order to make recommendations on the use of apheresis in a wide variety of diseases/conditions. The JCA Eighth Edition, like its predecessor, continues to apply the category and grading system definitions in fact sheets. The general layout and concept of a fact sheet that was introduced in the Fourth Edition, has largely been maintained in this edition. Each fact sheet succinctly summarizes the evidence for the use of TA in a specific disease entity or medical condition. The Eighth Edition comprises 84 fact sheets for relevant diseases and medical conditions, with 157 graded and categorized indications and/or TA modalities. The Eighth Edition of the JCA Special Issue seeks to continue to serve as a key resource that guides the utilization of TA in the treatment of human disease.




apheresis



What Is DRCA?DRCA is a procedure that allows a donor to give two units of red cells at the same time. This is done by a procedure called "apheresis," which separates whole blood into component parts such as red blood cells, platelets, and plasma. To remove red cells, a needle is placed in your arm, and the blood flows into a sterile, disposable plastic kit installed in a machine designed specifically for this purpose. As blood enters the machine, the bowl is spinning at high speed. This causes the components of the blood to separate so that the red blood cells can be siphoned into a blood bag. Plasma and other parts of the blood are then returned to you through the same needle. The process is repeated to collect two units of red blood cells.


UC San Diego Health operates the largest HSC collection facility in San Diego County. The HSC harvest apheresis program is accredited by many organizations, including the Foundation for the Accreditation of Cellular Therapy, the American Association of Blood Banks, the State of California and the U.S. Food and Drug Administration (FDA).


There are various types of stem cells. Hematopoietic stem cells, unlike embryonic stem cells, can be collected from the peripheral blood by apheresis. HSC are the progenitor cells that give rise to all the components of the bone marrow and immune system, including red blood cells, white blood cells and blood platelets.


Hematopoietic stem cell harvest apheresis is now the primary method for obtaining the cells that are transplanted in bone marrow transplantation. This procedure is used to treat various types of leukemia, lymphoma and other cancers, and occasionally for certain genetic diseases that lead to anemia or immune deficiency.


As the name suggests, bone marrow transplant (BMT) originally required placing a needle into the interior of a bone to obtain these cells. Nowadays, in more than 90 percent of cases, equivalent cells can be collected from the bloodstream by HSC harvest apheresis, avoiding the painful and more complex procedure of bone marrow aspiration.


The blood is separated and mononuclear white blood cells and peripheral blood stem cells are transferred to a collection bag. They are saved and frozen. The other blood components (plasma, red blood cells, platelets) circulate back to the patient through a return needle. One or two HSC harvests are usually sufficient to obtain enough cells from normal allogeneic donors, but in autologous cases some patients may have to undergo three, four or more daily apheresis procedures.


HSC harvest apheresis is a safe procedure with a few possible side effects. You may have discomfort at the needle site and occasional light-headedness during treatment. A nurse will check on you regularly during treatment and a physician will be onsite.


Background: Mostly published as case reports or series, the role of apheresis in hypertriglyceridemia (HTG)-related acute pancreatitis (AP) remains unclear. We performed a systematic review of available literature on this topic with specific focus on disease severity.


Conclusions: Apheresis effectively reduces serum TG levels. However, due to uncontrolled data, reporting bias and lack of a comparison group, definitive conclusions on the efficacy of apheresis in reducing AP severity cannot be made. We propose which patients may be best suitable for apheresis, type of studies needed and outcome measures to be studied in order to provide empiric data on the role of apheresis in HTG-related AP.


Automated blood collection (sometimes called apheresis, or ABC) is a special kind of blood donation. Instead of giving one pint of whole blood (as in a regular donation), an ABC donor gives only those components of the blood needed for patients that day.


The therapeutic apheresis program at UT Southwestern is recognized as one of the most prominent of its kind in the U.S., providing quality-of-life therapies to the Dallas-Fort Worth community and beyond.


Christopher Webb, M.D., and Sean Yates, M.D., are other faculty members who have also greatly advanced the field of apheresis through various clinical trials and publications. These efforts include optimizing management for sickle cell patients and advancing evidence-based treatment of thrombotic thrombocytopenic purpura (TTP), a rare blood disorder, LDL apheresis for recurrent FSGS, and ECP for lung transplant rejection, for example.


Our dedicated nursing staff is equally involved in furthering the field of apheresis. Several of our nurses are key members of ASFA and have performed clinical studies, published manuscripts, and presented educational sessions. They have played a key role in promoting the use of peripheral venous access for apheresis procedures, which has led to the reduction of central catheters use in our patients. In addition, our nurses have been recognized for their excellence in patient care, receiving honors including the DFW Great 100 Nurses and the DAISY Award.


As part of the care, we routinely perform a peripheral vein evaluation to avoid the need for central venous access. In addition, our apheresis physicians are readily available to consult and collaborate with the referring physician to develop a treatment plan.


Duke's therapeutic apheresis program for adults and children, uses advanced technology to treat a variety of medical conditions by separating blood into white blood cells, red blood cells and platelets, removing the components that cause disease, and returning healthy blood to the body.


Red Cross Therapeutic Apheresis Services are helping professionals save lives in your community every day. Nationwide, the American Red Cross performs more than 10,000 therapeutic apheresis procedures per year.


Three types of leukapheresis procedures are performed. The most common type is hematopoietic peripheral blood stem cell (PBSC) collection (autologous and allogenic). Bone marrow processing and white blood cell (WBC) depletion are also performed. Download pamphlet on Peripheral Blood Stem Cell Collection


For purposes of Medicare coverage, apheresis is defined as an autologous procedure, i.e., blood is taken from the patient, processed, and returned to the patient as part of a continuous procedure (as distinguished from the procedure in which a patient donates blood preoperatively and is transfused with the donated blood at a later date).


07/1992 - Provided coverage of apheresis when performed either in an inpatient or outpatient hospital setting or in a nonhospital setting if patient is under the care of a physician and a physician is present to direct and supervise the nonphysician services. Effective date 07/30/1992. (TN 59)


UAB is a national leader in Therapeutic Apheresis, having been in operation for almost 40 years. Our center was among the first to offer Extracorporeal Photopheresis (ECP) to treat patients with Cutaneous T Cell Lymphoma (CTCL) about 30 years ago. Nowadays, we also treat patients with heart and lung transplant rejection and graft-versus-host disease (GVHD) post-allogeneic hematopoietic progenitor cell (HPC) transplantation. Our annual volume nears 2500 procedures, including therapeutic plasma exchanges (TPE), ECPs and red cell exchanges for patients with acute or chronic complications of sickle cell disease. UAB has a comprehensive Adult Sickle Cell Program that works very closely with our service. Our Therapeutic Apheresis services are available at UAB main hospital for outpatients (routine procedures in the Apheresis Clinic in Jefferson Towers of UAB Hospital) and inpatients (routine and emergent procedures), including nights, weekends and holidays. Our service is staffed by highly trained and specialized personnel consisting of 4 Board-certified apheresis physicians, 1 nurse manager and 8 apheresis nurses.


The Apheresis Collection Facility (ACF) is located in the 15th floor of Jefferson Towers and operates Monday to Friday collecting HPC for transplants, as well as peripheral mononuclear cells for cellular therapies such as CAR-T and other experimental protocols. Two apheresis nurses are dedicated to the ACF and take excellent care of our patients and HPC donors.


Therapeutic plasma exchange or TPE is used to remove circulating autoimmune antibodies or immune complexes in several neurologic, renal and hematological conditions and to treat organ transplant rejections. We perform therapeutic cytapheresis procedures to remove blood cells from patients with hematological, oncological, or infectious disorders eliminating part of the pathologic process and leading to clinical improvement.


Therapeutic apheresis has been successfully used to treat many hematologic, neurologic, renal, rheumatic, and metabolic disorders. In most clinical situations, it is used to remove a pathogenic or toxic macromolecule, such as an antibody, an abnormal plasma protein, or other substance. 041b061a72


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