Apheresis to Additive Solutions

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Last updated: November 14, 2025
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Apheresis
Typically, a drop in hematocrit of __ (1) and a fall in platelet count of __ occur after each granulocyte donation.
3%
Typically, a drop in hematocrit of __ and a fall in platelet count of __ (2) occur after each granulocyte donation.
22%
 
 
Plasmapheresis
Serum total protein should be at least
6 g/dL
If the donor weighs 50 to 80 kg, not more than ____ WB should be removed at one time
500 mL
If the donor weights more than 80 kg , not more than ___ WB should be removed at one time
600 mL
FDA guidelines recommend ___ (14.4 L for donors weighing more than 175 pounds) as the maximum allowable plasma volume donated per year
12 L
For serial donors, RBC loss must not exceed ____ per week or ____ in an 8-week period
25 mL; 200 mL
_________________ undergoes no more than one procedure in a 4-week period.
Occasional plasmapheresis
________________ may donate more frequently than 4 weeks but no more than every 48 hours and no more than two donations in a 7-day period
Serial plasmapheresis
At the start of a serial apheresis program and at 4-month intervals, the donor must be tested for ______ (1) and _________, and __________ must be performed.
total serum/plasma proteins
At the start of a serial apheresis program and at 4-month intervals, the donor must be tested for ______ and _________(2), and __________ must be performed.
quantitative immunoglobulin levels
At the start of a serial apheresis program and at 4-month intervals, the donor must be tested for ______ and _________, and __________ (3) must be performed.
protein electrophoresis
When to check or test those 3 laboratory tests?
start of serial program and at 4-month interval
 
 
Plateletpheresis
The platelet count must be at least
150,000/uL or 150x10^9
Donor taking aspirin, Feldene, or aspirin-containing medications should be deferred for
2 days
donors on Plavix (clopidogrel) or Ticlid (ticlopidine) should be deferred for
14 days
A routine plateletpheresis procedure typically takes __________________.
45-90 minutes
Prior to each plateletpheresis procedure, a sample must be collected to determine the donor’s _____
platelet count
If donor is on their first time plateletpheresis or 4 weeks have already elapsed since the prior donation, is it necessary to determine their platelet count prior?
No
If no, when?
after collection
Each apheresis platelet unit is required to contain at least
3x10^11
If the product contains more than _______ of RBCs, a pilot sample must be attached to the product and used by the transfusing facility to crossmatch the product with the intended recipient.
2 mL
Platelets obtained by an apheresis procedure provide the equivalent of ________ units of whole blood–derived platelets (random-donor platelets). [2 answers; insert the word "or"]
6-8 or 8-10
If the donor is donating repeatedly for a specific patient, repeat testing need only be done every _______.
30 days
A platelet donor typically experiences an acute fall in platelet count of _____________ following apheresis donation
20-29%
 
 
Double RBC Pheresis
Weight female (pounds)
150 lbs
Weight male (pounds)
130 lbs
Height female (feet)
5'5 ft
Height male (feet)
5'1 ft
Hematocrit female; PUT THE WORD "AT LEAST"
at least 40%
Hematocrit male; PUT THE WORD "AT LEAST"
at least 40%
procedure is discontinued prior to completion and the total RBC loss is less than 200 mL, the donor can donate again within ___________, provided all other donation criteria are met.
8 weeks
If the RBC loss is greater than 200 mL but less than 300 mL, the donor should be deferred for ____________.
8 weeks
If the total RBCs lost is greater than 300 mL, the donor must be deferred for the full __________________
16 weeks
don't know how to phrase this but it says "whole blood / 100 mL or more is not returned"
8 weeks
Leukapheresis
Atypical therapeutic dose is at least ______________ granulocytes each day for 5 consecutive days.
1x10^10
Typically, a drop in hematocrit of _____ and a fall in platelet count of ______ occur after each granulocyte donation.
3%; 22%
A common sedimenting agent that enhances the separation of the white blood cells from the red blood cells during centrifugation
Hydroxyethyl starch
The disadvantage of that sedimenting agent is it is a ______; it expands the donor’s blood volume and remains in the circulation for extended periods of time.
colloid
given to the donor prior to the collection procedure; work by pulling the granulocytes from the marginal pool into the general circulation, thus increasing the supply of cells
corticosteroid
dosage when prednisone is used
60 mg
dosage when dexamethasone is used
8 mg
a recombinant hematopoietic growth factor that can produce ______ times the volumes of cells in each collection compared with other agents; quite well tolerated by the donor. What is this substance? answer with abbreviation
granulocyte colony-stimulating factor
a recombinant hematopoietic growth factor that can produce ______ times the volumes of cells in each collection compared with other agents; quite well tolerated by the donor. (range)
4-8
HPCs are also known as
peripheral blood stem cells
In HPCs collection through leukapheresis, what substance is given to the donors to stimulate the release of more HPCs into the peripheral blood.
cytokine analog
Examples of cytokine analogs (2; just use abbreviations)
G-CSF and GM-CSF
usual dose of either cytokine analogs
10 ug/kg/day
 
 
Donation Frequencies
Book: Plasma (frequent)
every 2 days (no more than 2 time in 7 days)
Book: Plasma (infrequent)
every 4 weeks (no more than 13 times/year)
Book: Platelets, single apheresis unit
every 2 days (no more than 2 times in 7 days; no more 24 times in 1 year)
Book: Platelets, double or triple units
every 7 days
Book: Granulocytes
every 2 days
Book: 2 RBC
16 weeks
Book: 1 RBC and 1 plasma and/or platelet
8 weeks before donating red cell
NVBSP: platelet
3 days
NVBSP: single red cell
12 weeks
NVBSP: single red cell + platelets
12 weeks
NVBSP: plasma
4 weeks
Therapeutic Apheresis
selectively remove RBCs, WBCs, or platelets
Cytapheresis
used to remove plasma when the pathological substance is found in the circulation
Plasmapheresis
Apheresis is a first-line treatment, alone or inconjunction with other therapies. What category?
I
The optimal role for apheresis has not been established. Treatment should be individualized based on clinical evaluation and assessment of the anticipated risks and benefits. What category? Roman numeral?
III
Apheresis is a second-line treatment, alone or in conjunction with other therapies
II
Apheresis is reported as either of no benefit or harmful in these conditions. Clinical applications should be undertaken only under an approved research protocol
IV
Most common TA procedure performed
Plasmapheresis
Apheresis is most efficient at removing the substance at the beginning (first portion) of the procedure and least efficient at the end. True or false
True
Because of the diminishing effect of increased plasma removal, it is recommended that approximately _____ plasma volumes be exchanged per procedure
1-1.5
The preferred method for lowering the platelet count is _____
medication
In therapeutic plateletpheresis, platelet will be decreased by _____
30-60%
has been used to treat patients with hyperleukocytosis, defined as a WBC or circulating blast count of over _____
100,000/uL
Leukostasis is more common in patient with ___ > _____
AML > ALL
A single procedure should reduce the WBC count by _____; however, more than one procedure may be necessary due to rapid mobilization of cells from the extravascular compartment.
30-60%
To achieve an adequate reduction in the WBC count, up to _____ of fluid may be removed, necessitating the use of a replacement fluid.
1 L
Erythrocytapheresis is commonly performed in patients with ________
sickle cell disease
The therapeutic goal is to decrease the level of hemoglobin S to less than ________
30%
When erythrocytapheresis is performed to decrease parasitic load, _______ volume red blood cell exchange is done
1.5-2
most common replacement fluid for TPE
5% human serum albumin
Used for up to one-third of the replacement volume
Crystalloid
contains all the constituents of the removed plasma and thus would appear to be the optimal replacement fluid for TPE procedures
FFP
Why is FFP associated with allergic reaction?
citrate toxicity
Where are HPCs found during centrifugation?
upper part of buffy coat
How many apheresis collections are usually needed to produce an acceptable “dose" of HPCs
at least 1, sometimes 2 or 3
Each HPC collection lasts ____
4-6 hours
HPCs express the cell surface glycoprotein
CD34
_____ daily injections of GCSF are typically required to mobilize sufficient HPCs for collection
4-5
Most common reaction in HPCs
citrate toxicity
Medical term for numbness or tingling around the mouth
paresthesia
Electrolyte imbalance in citrate toxicity
hypocalcemia
is the regulatory restriction limit for extracorporeal volume during apheresis to avoid hypovolemic reaction
10.5 mL/kg
The patient’s extracorporeal blood volume (ECV) should be less than ___ of the total blood volume (TBV) in order to minimize the risk of hypovolemia.
15%
Blood Preservatives/ Additives/ Rejuvenation/ Freezing/ Deglycerolization
No. of red blood cells must remain viable at the end of the permitted storage period. This is called?
post-storage viability
At least ___ of the red blood cells must remain viable at the end of the permitted storage period
70%
No. of red cells that have been transfused should remain viable for 24 hours. This is called?
post-transfusion viability
At least ____ of the red cells that have been transfused should remain viable for 24 hours.
75%
Shipment of blood must be maintained at a temperature of ___
1-10C
Ice or other cooling devices ______ physically be in contact with blood unit to prevent hemolysis
should not
Shelf life: ACD, CPD, CP2D
21 days
Shelf life: CPDA-1
35 days
Shelf life: CPDA-2
42 days
Shelf life: Heparin
2 days
Acts as anticoagulant, chelates calcium
calcium
Provides energy or glucose to RBC (food for cells); Substrate of ATP
dextrose/glucose
Lowers pH thus prevent caramelization
citric acid
Maintains pH during storage; necessary for maintenance of adequate levels of 2,3-DPG; Increase ATP levels
monobasic sodium phosphate
Production of ATP (Improve RBC survival from 21 to 35 days); increases ADP levels, thereby driving glycolysis towrd synthesis of ATP
adenosine
used only for priming heart-lung machines
Heparin
preserving solutions that are added to the RBCs after removal of the plasma with or without platelets.
Additive solutions
Additive solutions reduce hematocrits from around ____ (1) to around _____ with a volume of approximately 300 to 400 mL.
65-80%
Additive solutions reduce hematocrits from around ____ to around _____ (2) with a volume of approximately 300 to 400 mL.
55-65%
RBCs stored for 42 days in AS-_, -_, -_ demonstrated a mean 24-hour post-infusion survival of greater than 75 percent, the minimum requirement for satisfactory RBC survival
1,3,5
AS-1, -3, -5 contain
saline, adenine, glucose
AS-1, -5, -7 contain ____ which protects against storage-related hemolysis
mannitol
AS-3 contains ____which also protects against storage-related hemolysis
citrate and phosphate
Acts as a RBC membrane stabilizer/stabilizing agent
mannitol
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