Apheresis HF#6300

 

Apheresis uses a centrifuge 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. 

 

1. Plasmapheresis 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, all over 2-3 hours.
2. Leukapheresis or platelet pheresis removes white cells and platelets.  The red cells and plasma are returned, all over 2-3 hours.
3. Erythrocytapheresis removes red cells from the blood stream and replaces them with donor red blood cells.  This takes 1-2 hours.
4. Photopheresis selects white blood cells and exposes them to ultraviolet light before they are returned to the body.  After the white cells are gathered, they are injected with the drug 8-methoxy psoralen, which makes the cells more sensitive to ultraviolet 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.

 

The side effects of all of the above treatments can include dizziness, lightheadedness, 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.  The pheresis doctor will further explain the treatment and obtain your consent before starting the treatment. 

 

The treatment is done in your hospital room or in the Outpatient Transfusion Service, C5/550.  A nurse will perform the treatment.

 

Before the Treatment

 

Blood is drawn from your arm vein by a needle attached to a blood tubing set.  The cells and replacement 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 pheresis machine.  Vital signs will be checked often.

 

The nurses will be with you at all times.  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.

 

During the Treatment

 

Pheresis takes about two hours.  If there is space, family members can be with you.  Your nurse can provide you with a sandwich, soda, or juices if you would like.  You may also bring in something from home to eat or drink.  You may wish to read a book or watch TV.  There is a VCR for patient use.

 

Most people report that lying still is their biggest problem during the treatment.  Let your nurse know if you are having any problems during treatment.

 

Common Issues Which Arise during Treatment

 

• Sometimes blood flow can not be achieved 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 begin to 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.  You should tell your nurse right away if you have any of these symptoms.

 

After Treatment

 

Your catheter will be flushed, or both needles will be removed.  Pressure dressings to needle sites will be applied and need to remain on for a few hours.  You can resume your normal routine when your puncture sites have sealed later that day.

 

Your doctor may have you repeat the treatment, if it is needed, on another day.

 

If you are home and notice problems, you can call the transfusion center between 8am-8pm 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 that is worse than a bruise and getting worse instead of better (increased redness, pain, 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.)

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 02/13/2013

Copyright © 02/13/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6300

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