What is Apheresis?
Apheresis uses a machine to spin the blood and separate it into parts. A drug is added to keep the blood from clotting. The blood parts that are leading to illness are then taken away. The healthy parts are returned to your bloodstream. At times, healthy, donor blood parts are also returned to you.
Plasmapheresis (plasma exchange) involves taking away of the plasma which is the liquid portion of blood. Plasma is replaced with fresh frozen plasma, albumin solution, and/or saline. Red cells, white cells, and platelets are returned, which takes 2-3 hours.
Leukapheresis or plateletpheresis removes white cells and platelets. The red cells and plasma are returned, which takes 2-3 hours.
Erythrocytapheresis (also known as red cell exchange) removes red cells from the blood stream and trades them with donor red blood cells. This takes 1-2 hours.
Photopheresis selects white blood cells and exposes them to ultraviolet light. The cells are returned to the body. After the white cells are gathered, they are injected with the drug 8-methoxy psoralen. This makes the cells more sensitive to UV light. The treated white cells are then put back; they will react against the diseased white cells in your body. Patients who have this will need to wear prescription sunglasses for 24 hours after each treatment since the drug used will make the lens of the eye sensitive to sunlight. Also, you should avoid sunlight as much as you can for 24 hours.
What are side effects of these treatments?
The side effects of all the treatments can include dizziness, faintness and nausea due to the shifting of the blood volume. Some people have tingling toes, fingers, and lips because of the anti-clotting drug that is added. These symptoms can be treated with good success.
If you are receiving photopheresis, there is a possible risk of clotting. This is a rare but possible serious side effect.
If you are receiving red cell exchange, there is a possible risk of bleeding due to platelet loss.
If blood products are used, then each one has a small risk of transfusion reactions (rarely, severe reactions, and extremely rare fatal reactions). Also, there is a risk of a transfusion-transmitted infection.
The apheresis doctor will further explain the treatment and obtain your consent before starting the treatment.
Where do I go for this treatment?
The treatment is done in your hospital room or in the Infusion Center, C5/350. A nurse will perform the treatment.
What can I expect before the treatment?
Blood is drawn from your arm vein by a needle attached to a blood tubing set. The cells and extra fluid are then returned to you through a needle in your other arm. Sometimes, we do not get a good blood flow from arm veins. Then, a catheter needs to be placed into a large vein in your neck or chest. This is done by the doctor. Your IV lines will be attached to the apheresis machine. Vital signs will be checked often.
The nurses will be with you always. If you have any feelings of dizziness, chest pain, muscle cramping, or itching, let your nurse know right away. Many of these symptoms can be treated with good success.
What can I expect during the treatment?
Apheresis takes about two hours. If there is space, family members can be with you. Your nurse can provide you with a drink if you would like. You may also bring in something from home to eat or drink. You may read a book or watch TV. We have DVD players and a DVD library. Hospital WIFI is also available.
Most people report that lying still is their biggest problem during the treatment. Let your nurse know if you have any problems during treatment.
What are some common issues which arise during the treatment?
Sometimes blood flow cannot be reached from arm veins. In such cases, a catheter needs to be placed, which involves minor surgery.
Changes in blood volume may make some people feel dizzy or light-headed. You should tell the nurses right away if you feel this way.
The drug which is added to prevent clots as well as the replacement fluids or blood parts might cause some people to notice a sour taste in the mouth. Tingling around the lips, or pins and needles-type tingling in fingers and toes may occur. You should tell your nurse right away if you have any of these symptoms.
What can I expect after the treatment?
Your catheter will be flushed, or both needles will be removed. Pressure dressings to the needle sites will be applied and need to remain on for a few hours. Right after your first procedure, we recommend you not engage in hard physical activity that same day. Beyond the day of your first test, you usually can resume your normal routine. Check your puncture sites to make sure they have sealed. Ask your doctor if you are unsure.
Your doctor may have you repeat the treatment, if needed, on another day.
When would I need to contact the clinic with a problem?
If you are home and notice problems, you can call the Infusion Center between 8am-8pm M-F at (608) 263-8369. After hours, go to the nearest ER if:
You have a fever more than 101.5° F.
You have pain at the IV site.
You see increased redness, pain, or warmth.
Your IV site or catheter bleeds. Apply pressure to the site or try to clamp the catheter above the site of the bleeding before you go.