Therapeutic erythrocytapheresis

This chapter focuses on the therapeutic procedure known as therapeutic erythrocytaphereis. Therapeutic erythrocytapheresis is also known as red blood cell exchange and this procedure involves the removal of whole blood and passing it through a medical device which separated the red blood cells (RBCs) from the other blood components. The RBCs are discarded, and the other blood components are returned to the patient and the removed volume is replaced by banked RBCs or saline/albumin. Therapeutic erythrocytapheresis is performed most commonly for the exchange of dysfunctional RBCs or infected RBCs with donor RBCs. Therapeutic erythrocytapheresis is indicated in complications of sickle cell disease such as multiorgan failure and stroke. Erythrocytapheresis is preferred over simple transfusion since the HbS concentration is reduced rapidly by removing HbS RBCs and replacing HbS RBCs with HbA RBCs without increasing blood viscosity and volume overload. Parasitemia in malaria leads to hemolysis and release of inflammatory cytokines resulting in fever, malaise, chills and headache and erythrocytapheresis can be used the treatment of severely ill patients with parasitemia and may result in rapid clinical improvement.

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Author Beth H. Shaz Pathology