Guidelines on the Use of Therapeutic Apheresis in Clinical Practice – Evidence‐Based Approach from the Writing Committee of the American Society for Apheresis: The Eighth Special Issue

Abstract

The American Society for Apheresis (ASFA) Journal of Clinical Apheresis (JCA) Special Issue Writing Committee is charged with reviewing, updating and categorizing indications for the evidence‐based use of therapeutic apheresis (TA) in human disease. Since the 2007 JCA Special Issue (Fourth Edition), the committee has incorporated systematic review and evidence‐based approaches in the grading and categorization of apheresis indications. This Eighth Edition of the JCA Special Issue continues to maintain this methodology and rigor in order to make recommendations on the use of apheresis in a wide variety of diseases/conditions. The JCA Eighth Edition, like its predecessor, continues to apply the category and grading system definitions in fact sheets. The general layout and concept of a fact sheet that was introduced in the Fourth Edition, has largely been maintained in this edition. Each fact sheet succinctly summarizes the evidence for the use of TA in a specific disease entity or medical condition. The Eighth Edition comprises 84 fact sheets for relevant diseases and medical conditions, with 157 graded and categorized indications and/or TA modalities. The Eighth Edition of the JCA Special Issue seeks to continue to serve as a key resource that guides the utilization of TA in the treatment of human disease.

Therapeutic plasma exchange in pediatric intensive care: Indications, results and complications

“…Therefore indications and possible complications are based on adult studies. However, it is a highly specialized procedure and should be performed by experienced staff in a specialized center to minimize risk of complications …”

“…There are some studies showing good response to TPE in thrombocytopenia‐associated multiple organ failure . Encouraging results were reported regarding TPE use in meningococcemia and survival was increased to 87% with TPE use . However, there are a few clinical studies performed showing varying results .…”

“…It is a procedure of plasma removal with its ineligible plasma component; plasma is separated from whole blood and replaced with plasma or albumin. This method enables removal of pathological substances such as antibodies, immune complexes, cytokines, and endotoxins while also allowing replacement of missing plasma components (atypical hemolytic uremic syndrome—aHUS) …”

“…The guidelines of ASFA are the main reference in decision making regarding indications in pediatric and adult patients. When taking indications in consideration, it can be seen that number of diseases which can be treated with TPE has increased significantly over the years …”

Leukocytapheresis in nonmobilized donors for cellular therapy protocols: Evaluation of factors affecting collection efficiency of cells

“…The mononuclear cell (MNC) layer is located between the dense polymorphonuclear cell/red blood cell layers and the less dense platelet layer . Leukocytapheresis is an apheresis procedure in which blood of the patient or the donor is passed through a medical device which separates white blood cells (WBCs), collects the selected cells, and returns the remainders of the patient's or the donor's blood with or without the addition of replacement fluid such as colloid solution or a combination of crystalloid/colloid …”