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Apheresis is the process of removing whole blood from a donor, separating the blood into cellular and soluble components, removing a specified element and then returning the remainder of the blood to the donor. There are several kinds, all named after which element of the blood is removed (e.g., red blood cells, platelets or plasma).  

Below, we explore the different types of apheresis, their broad applications and the techniques through which they’re completed.  

What Is Apheresis Used For?

Apheresis has two main purposes: to treat various disorders or to collect cells for clinical trials or research purposes. The former is broadly known as therapeutic apheresis (TA). The latter is known as donor or cellular therapy apheresis.

The 2016 evidence-based guidelines for therapeutic apheresis issued by the American Society for Apheresis (ASFA) lists over 80 conditions for which TA can be used. The conditions range from multiple sclerosis to lung transplantation to acute liver failure.

In addition to research and clinical trials, cellular therapy apheresis can be used to collect cells from healthy donors for patients needing CAR-T cell therapy or bone marrow transplantation.

What Are the Different Types of Apheresis?

There are many different types of therapeutic and cellular therapy apheresis. Several common procedures are discussed below.

Other examples of apheresis include extracorporeal photopheresis, immunoadsorption and therapeutic phlebotomy.

How Is Apheresis Completed?

The two main ways to separate the whole blood components during apheresis are centrifugation and membrane filtration.

Centrifugal apheresis is a highly efficient process, achieving a plasma extraction rate of close to 80%. It can be done intermittently or as a continuous flow and requires lower blood flow rates, allowing it to be performed using either peripheral or central venous access.

Intermittent flow centrifugation involves repeated cycles of blood being drawn, processed, and re-infused. While it only uses a single site venous access, the procedure time is longer. Continuous flow centrifugation, on the other hand, removes, processes and re-infuses the blood components simultaneously. This is a faster process, but requires two sites of vascular access.

Membrane filtration filter the whole blood through membranes. Membrane filtration is less efficient with a much lower plasma extraction rate of approximately 30%.

Ongoing innovation in cellular therapies will allow many different types and parts of cells to be used to treat a variety of diseases and conditions. Venous access is crucial to the success of an apheresis procedure. Often this can be performed using peripheral IV lines, but sometimes central venous access may be required or more appropriate.  Central venous access can be temporary or long term (eg. tunneled catheters, subcutaneous ports, fistulas).

Comprehensive Cell Solutions welcomes your inquiries concerning the outsourcing of leukapheresis. Your team can initiate a request by calling (866) 956-6922.