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Getting Ready for Apheresis

For Patients

What is apheresis? How does it work?

Apheresis [AY-fur-EE-sis] is the removal of certain • You will sit in a chair or lie in a bed. blood cells. • We place a needle in the vein of each arm. We We take blood from your vein and pass it through a remove blood from one arm and pass it through machine. The machine collects a part of your blood. a machine. The rest of the blood is returned to your body. • As the blood leaves your body, it is treated There are several types of apheresis. Your doctor will with medicines (citrate and heparin) to tell you which type you will have: prevent clotting.

☐ Red blood cell exchange removes some of your • The machine spins, separating the parts of the red blood cells. These are replaced by a donor’s blood. This allows us to collect the needed cells. red blood cells. This takes 2 to 3 hours. • The rest of the blood flows back into your body ☐ Plasma exchange removes plasma from your through the needle in your other arm. blood. The plasma is replaced with a donor’s plasma, 5% albumin (a protein) or both. This If your veins are too small for needles, you may need takes 2 to 3 hours. to have a catheter (a tiny tube) placed into a larger vein. The vein is usually in the lower neck, upper ☐ Plateletpheresis removes some of your platelets chest or groin (area between your leg and trunk). (cells that help your blood to clot). This takes 2 to Doctors from another department will explain 3 hours. how the tube is placed. They will ask you to sign a consent form before they insert the tube. ☐ Leukapheresis removes some of your white blood cells. This takes 2 to 3 hours. If you are small or are low in red blood cells, we may need to put red blood cells into the machine. ☐ Photopheresis removes some of your white blood (This is called “priming the machine.”) The blood cells. The cells are mixed with a medicine called cells come from a donor. We will discuss the risks methoxsalen and exposed to special lights. The of blood transfusion before you receive any donated cells and medicine are then put back into your blood cells. body. This takes 3 to 4 hours.

For informational purposes only. Not to replace the advice of your health care provider. Copyright © 1997, 2008 Fairview Health Services. All rights reserved. Clinically reviewed by Linda Meulners, RN. SMARTworks 169504 – REV 04/21. Page 2 of 2

How do I get ready for apheresis? If you have photopheresis: You may be more sensitive to bright sunlight. You should wear In most cases, you don’t have to do anything special sunscreen and sunglasses for one day after treatment. to prepare. If you receive donated blood products (during red What are the risks of apheresis? blood cell exchange, plasma exchange or priming the machine): We will discuss the risks of blood Apheresis should help your doctor treat your disease. transfusion in advance. But not all patients get better with this treatment. When should I call the doctor? There are risks with any treatment. Known risks include: After the procedure, please call your doctor if you have: • Feeling tired, faint or dizzy. • Bleeding that doesn’t stop. • Headache, nausea (feeling sick to your stomach) and vomiting (throwing up). • Fever.

• Bleeding, bruising, pain, injury, clot or infection at • Pain where a needle or tube (catheter) was placed. the needle sites. • Seizures. • Low calcium and other changes in your blood. (We may give you calcium while you donate.) • Trouble breathing.

• Chills, cramping, numbness, tingling or anxiety • Red urine. (sometimes caused by the medicine citrate). • Nausea or vomiting. • Allergic reaction. • Other health concerns. • Blood loss or damage to red blood cells. If your symptoms are severe, call 911. • Loss of platelets. (Platelets help your blood clot when you are bleeding.) What happens to any blood that is collected?

• Seizures. In most cases, the cells are thrown away. If we need to test your cells or use them for research, we will ask • Air in the heart or lungs (embolus). for your consent.

• Serious problems such as heart attack, stroke and What are my other options for treatment? death (very rare). This depends on your disease. Your doctor will talk If you have a reaction or injury during this process, to you about any other options you may have. If you we will treat you as needed. This treatment will be have questions, be sure to ask them. billed to you or your insurance company.