Hemapheresis

Hemapheresis is a therapeutic elimination procedure where we try to improve the patient's condition by removing some component of the blood, like cells or parts of the plasma.

Principle
The component separators work on the centrifugation principle. The collected blood is mixed with an anticoagulant, directed to the separator, where the requested component is separated and the rest of the blood is returned to the patient's body.

Depletion Interventions
They reduce the amount of multiplied blood elements.
 * Leukocyte apheresis: in both acute and chronic leukemias, when the number of leukocytes exceeds 100*109/l.
 * Erytrocytapheresis: it's indicated for primary polycythemia, haemochromatosis and haemosiderosis.
 * Platelet apheresis: if the number of platelets exceeds 1500*109/l, eg in essential thrombocythaemia, primary polycythaemia, myelofibrosis.

Plasma Exchange, Exchange Erythrocytapheresis
We remove a larger volume of plasma or blood elements from the circulation and replace them with solutions of crystalloids and colloids, or with blood elements and plasma from a healthy donor. Approximately 60 % of the circulating pathological component can be removed in one treatment cycle. It is less effective in trying to remove eg IgG, imunocomplexes and LDL particles, but it is possible to use the technique of extracorporeal immunoabsorption, that may be really helpful.

Indications

 * autoimmune diseases
 * multiple myeloma
 * blood clotting disorders
 * hyperviscous syndrome

Related articles

 * Principles of supportive treatment in hematology