In this Article

• What is apheresis?
• How is apheresis performed?
• What are some possible complications of apheresis?
• What diseases can be treated with apheresis?
• What are contraindications to apheresis?
• Hemapheresis Index

How is apheresis performed?

All apheresis procedures involve connecting the blood in the patient/donor's veins through tubing to a machine that separates the blood components. The separation is done by either a centrifuge process or a filtration process on the blood in the machine. After the separation, the desired component of the blood is removed, while the remainder of the blood components are reinfused back into the patient. The entire procedure is painless and typically takes about two hours, or only slightly longer than a conventional blood donation.

What are some possible complications of apheresis?

Serious complications of donor apheresis are rare. Minor complications of donor apheresis can include bleeding at the donation site and feelings of lightheadedness that usually resolve quickly.

More serious complications can occur when apheresis is used to treat serious conditions and include:

• bleeding and a tendency to bleed (because clotting factors are removed),
  
  
• infection and a tendency toward infection (because the immune system is somewhat suppressed when antibodies are removed),
  
  
• low blood pressure (as fluids are removed),
  
  
• muscle cramping (as low blood calcium can occur and other electrolytes can be imbalanced).

What diseases can be treated with apheresis?

When used in a therapeutic manner, the apheresis procedure is individualized regarding the frequency of treatments, the volume of blood or components to be removed, and the type of solution used for volume replacement.

The following list of conditions for which apheresis may be of benefit is not all-inclusive. Apheresis can be used in the treatment of:

• myasthenia gravis,
  
  
• Waldenstrom's macroglobulinemia,
  
  
• Goodpasture's syndrome,
  
  
• familial hypercholesterolemia,
  
  
• hyperviscosity syndrome (such as mixed cryoglobulinemia, thrombotic thrombocytopenic purpura),
  
  
• the HELLP syndrome of pregnancy,
  
  
• clogging of blood vessels (leukostasis) cause by severely elevated white blood count in leukemia, and
  
  
• severely elevated platelet counts in leukemia or myeloproliferative disorders.

Apheresis can also be effective in certain cases of:

• systemic lupus with life-threatening complications,
  
  
• severe vasculitis,
  
  
• polymyositis or dermatomyositis,
  
  
• severe rheumatoid arthritis,
  
  
• rapidly progressive glomerulonephritis,
  
  
• chronic autoimmune polyneuropathy, and
  
  
• in cases of solid organ transplantation with a high risk of antibody-mediated rejection of the transplant.

Suggested Reading by Our Doctors

• Complete Blood Count (CBC) - A complete blood count (CBC) measures the concentration of white blood cells, red blood cells, and platelets in the blood and aids in the diagnosis of conditions and diseases such as anemia, malignancies, and immune disorders.
• Rheumatoid Arthritis - Learn more about rheumatoid arthritis, an autoimmune disease that causes chronic joint inflammation, which has symptoms that include stiffness, fever, muscle and joint aches, loss of appetite, and fatigue. Treatment of rheumatoid arthritis incorporates the use of first-line drugs (aspirin and corticosteroids for pain and inflammation) and second-line drugs (methotrexate and hydroxychloroquine to prevent joint destruction and promote remission).
• Liver Transplant - Information on liver transplant, the tests required, finding a match, complication, antirejection medications, and the follow-up necessary.

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