GROUP #6

NAME: Abesamis, Maria Feliza SCORE:

Aquitania, Mary Christelle
Cruz, Mark
Dimaano, Ysrael
Diosomito, Maria Ana
Ynoli
Fauni, Mark Bryan

SECTION: 3E – Medical Technology DATE: 2011-03-09

1. Define APHERESIS or HEMAPHERESIS. What is Therapeutic Hemapheresis?

APHERESIS is a term of Greek derivation that means “to separate or to
remove”. It is a method of blood collection in which whole blood is
withdrawn, a desired component is separated and retained, and the
remainder of the blood is returned to the donor. (Harmening, 2005)

LEUKOAPHERESIS – apheresis from which leukocytes are

removed from the donor’s blood
PLATELETPHERESIS – apheresis from which platelets are
removed from the donor’s blood
ERTHROCYTAPHERESIS – apheresis from which erythrocytes are
removed from the donor’s blood
PLASMAPHERESIS – apheresis from which plasma are removed
from the donor’s blood

THERAPEUTIC HEMAPHERESIS or Plasma Exchange is the process of

separating and removing offending agents in the plasma causing clinical
symptoms through the use of a blood cell separator. (Harmening, 2005)

2. Enumerate the donor selection requirements for a pheresis donor?

Apheresis donors must meet the requirements established by the standards of
AMERICAN ASSOCIATION OF BLOOD BANKS (AABB) (Harmening, 2005)
 Donors undergoing an occasional procedure (performed no more
frequently than once every 8 weeks) must meet the same criteria as a
whole blood donor.
 Careful monitoring of weight, blood cell counts, serum protein levels and
quantification of immunoglobulins are required.
 The interval between apheresis procedures should be at least 48 hours
and the amount of erythrocytes loss should not exceed 25ml per week.
  The maximum amount of plasma that can be retained during a procedure
should not exceed the amount approved by the Food and Drug
Administration (FDA).
 The frequency of donation, other specific requirement and additional
testing are different for the type of apheresis.

3. Discuss shortly the achievements of the following people in apheresis procedure.

a. Duke – developed the bleeding time
b. Dillard – developed the granulocyte theraphy
c. Edwin J. Cohn – adapted a continuous flow cream separator patiented by
DE LAVAL in 1878 to separate plasma from blood as to declycerolized
frozen blood (International Immunology Foundation)
d. Bierman – reported the hematologic changes observed in the donors after
leukophoresis. Further studies, if leukocyte depletion and replenishment
led to improved designs of the separation bowls and equipment (Excerpt
from Blood, American Society of Hematology, Inc. (Beirman))
e. Allen Latham and Arthur Little – developed discontinuous flow set of
bowls based on the basic principle of Cohn

4. Describe the following cytapheresis machines.

a. AMINCO – is used for plasma exchange to remove the offending agent in
the plasma causing the clinical symptoms
b. COBE/IBM 2997 – employs continuous flow membrane filtration for
therapeutic plasma exchange
c. COBE SPECTRA - employs continuous flow centrifugation and it is used
to collect peripheral blood progenitor cells (PRBCs). It was enhanced
which allows its use as one or two arm platelet collection device
d. FENWAL CS-3000 – is an example of machine that employs continuous
flow centrifugation from which the process of phlebotomy, separation and
reinfusion is uninterrupted
e. Intermittent flow cell separator by haemonetics – employs intermittent
flow centrifugation in which the procedure can be done with only
venipucture (one arm procedure that is the blood is drawn and reinfused
through the same needle). The amount of time for the process can be
reduced if both arms are used: one for phlebotomy and one for reinfusion
(two arm procedure).
5. Enumerate the 4 categories of disease in response to therapeutic apheresis.
Give 5 examples of disease in each category.
Disorder are recognized in four (4) categories as published in a special issue of
Journal of Clinical Apheresis in 1993 and according to the American Association
of Blood Banks, and the American Society for Apheresis

CATEGORY I – refers to diseases in which apheresis is an established therapy

as shown by controlled studies (e.g. Chronic inflammatory demyelinating
polyneurophathy, Cryoglobulinemia, Goodpasture’s syndrome, Guillian-Barre
syndrome, Hyperviscosity syndrome)

CATEGORY II – refers to disease in which apheresis is an acceptable theraphy

but is supportive to other first line therapies (e.g. Hemolytic uremic syndrome,
Cold agglutinin disease, Hyperparasitemia, Rapidly progressive
glomeronephritis, Drug overdose and poisoning)

CATEGORY III – refers to disease in which no controlled studies are available to

support the efficacy of apheresis (ABO incompatible organ or marrow
transplantation, Thyroid storm, Multiple organ sclerosis, Pure RBC aplasia, Warm
and autoimmune hemolytic anemia)

CATEGORY IV – refers to diseases in which apheresis is no benefit (Acquired

Immune Deficiency Syndrome, Amytrophic lateral sclerosis, Aplastic anemia,
Fulminant hepatic, Lupus nephritis)

6. Identify what is asked for in the following questions.

Acid Citrate a. Most common anticoagulant used in apheresis

Dextrose
Hydroxyethyl b. Most commonly used sedimenting agent in
Starch apheresis
3 x 1011 platelets c. In plateletpheresis, AABB standards require that
75% of apheresed platelets contain at least how
many platelets_______________.
45-90 minutes d. Plateletpheresis procedure should take how long to
get the desired amount of platelets
30-50% e. After an apheresis platelet donation, the platelet
count may drop as how many percent
_____________%
3-28 days f. Time interval between platelet pheresis donation.
 Several days g. Granulocytapheresis procedure should take how
(Minimum of 4) long _____________.
until 1 clinical
defervescence of
bone marrow
recovery occurs
Predonation h. What is usually given to a donor prior to
Corticosteroid granulocytapheresis several hours prior to
Stimulation procedure to raise the peripheral granulocyte count
to 8,000 – 15,000 / μL
No i. Can donors with hypertension, diabetes mellitus,
active stomach ulcers or history of tuberculosis
donate granulocytes?
30% j. During continuous plasma exchange in therapeutic
hemapheresis, the removal of one plasma volume
with replacement of an equivalent amount of fluid
will result to a removal of how much ________%
pathologic substance?

BIBLIOGRAPHY

Beirman, H., [Link]. (1963) Leukapheresis in Man. (Hematologic Observations in

Patients with Leukemia and Myeloid Metaplasia`). Blood, 1963. (Vol. 21,
No. 2, pp164-182)

Harmening, D. (2005). Modern Blood Banking and Transfusion Practices, 5th ed.,
F.A. Davis Company, US: Philadelphia.

Rudmann, S. (1995). Textbook of Blood Banking and Transfusion Medicine. W.B.

Saunders Company. USA: Philadelphia.

The DeLaval Cream Separator. May 10, 2010. International Immunology

Foundation. March 6, 2011.
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