Apheresis

The components which are separated and withdrawn include:

• Plasma (plasmapheresis)
• Platelets (plateletpheresis)
• Leukocytes (leukapheresis)

Therapeutic Apheresis
The purpose of therapeutic apheresis is to remove a component of the blood which contributes to a disease state. Examples include:

Plasmapheresis: within the plasma are contained antibodies and antigen-antibody complexes that may contribute to the deleterious effects of autoimmune diseases. Removal of the plasma (and replacement with saline solution) will help to reduce circulating antibodies and immune complexes. In rare circumstances, excess blood proteins are present that may cause circulatory problems. Examples of these diseases include:

• Waldenstrom's macroglobulinemia
• Myasthenia gravis
• Guillain-Barré syndrome
• Hyperviscosity Syndromes
• Paraproteinemia
• Cryoglobulinemia
• Goodpasture's syndrome

Plateletpheresis: rarely, in myeloproliferative disorders, the platelet count can be very high (thrombocytosis). Removal of platelets can help to avoid complications of thrombosis and bleeding.

Leukapheresis: in some cases of leukemia with very high white blood cell counts, removal of the excess leukocytes may help to prevent complications of thrombosis.

Stem Cell Harvesting: the small number of circulating bone marrow stem cells can be harvested to use in transplantation procedures.

DONATION BY APHERESIS
The process of apheresis has become essential in providing blood components for therapy. A volunteer donor will undergo apheresis to supply specific components. The process takes a couple of hours. Examples include:

Plateletpheresis: this is the most common means for supplying HLA matched platelets to patients who have become HLA sensitized and require platelets from a single donor whose HLA type matches theirs.

Plasmapheresis: the plasma can be removed to supply blood components such as clotting factors. Donors can give plasma via this mechanism more often than they can donate whole blood.

Leukapheresis: the leukocytes (specifically the granulocytes) can be harvested from a donor to supply granulocytes to help fight infection in patients such as neonates.

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