Apheresis

Supervisor :

Present by:

Mr. Ghorbani

Ehsan Masjedi

Outline

What’s?! What is advantage ? Mechanism Types

What’s that?!

Apheresis:Derives from Greek,

A technique in which whole blood is taken and separated

History of Apheresis

Hippocrates; 460 – 377 bc

History of Apheresis

History of Apheresis

History of Apheresis

Tuesday, 9 April, 13

Use of Apheresis

Donor facilitate collection

Therapy removing undesired substances

Mecanism

Centrifuge Filteration Adsorption

The main base

centrifuge

The main base

Specific weight

Size

Plasma 1,026 1-4 μm

Platelets 1,040 6-10 μm

Lymphocytes 1,077 10-30 μm

Monocytes 1,080 10-15 μm

Eosinophils 1,082 9-15 μm

Neutrophils 1,088 12-15 μm

Erytrocytes 1,100 6-8 μm

The main base

Continuous flow centrifuges ( CFC )

Intermittent flow centrifuges ( IFC )

Filteration

AdsorptionChromatography

• Pathogenic Ab • LDL • Immune complexes• Bile acids• …

• Staphylococcal A proteins• Dextran sulfate• Anti bodies• Charchol• …

Adsorption Staphylococcal A proteins

Dextran sulfate

IgG 1, 2, 4 Types of immune complexes containing Trombocytopeny refractory autoimmune

Familial Hypercholesterolemia

Extracorporeal photopheresis (ECP)

• Uv• 8MOP ( 8 met oxy psoralens )• CTCL ( cutaneous T cell lymphoma )• Autoimmune Diseases• GVHD (Graft-versus-host disease )

RBC exchange Leukocytapheresis Extracorporeal photopheresis Platelet apheresis Thrombocytapheresis Erythrocytapheresis

Plasmapheresis LDL apheresis Plasma exchange

cytopheresis

plasmapheresis

Crystalloid Albumin 5% FFP colloidal Starch ( 3-6 % )

Replacement fluids

Anticoagulants ACP ( acid citrate dextrose ) Heparin

• Category I• Category II • Category III • Category IV

American Society for Apheresis ( ASFA )

Acute inflammatory demyelinating polyneuropathy (Guillain-Barré syndrome) (plasma exchange) • ANCA-associated rapidly progressive glomerulonephritis (Wegener’s Granulomatosis) (plasma exchange) • Anti-glomerular basement membrane disease (Goodpasture’s syndrome) (plasma exchange) • Babesiosis (RBC exchange) • Cardiac allograft rejection prophylaxis (photopheresis) • Chronic inflammatory demyelinating polyneuropathy (plasma exchange) • Cryoglobulinemia (plasma exchange) • Cutaneous T-cell lymphoma; mycosis fungoides; Se´zary syndrome, erythrodermic (photopheresis) • Homozygous familial hypercholesterolemia (plasma exchange or selective adsorption) • Hyperleukocytosis, leukostasis (leukocytapheresis) • Hyperviscosity in monoclonal gammopathies, treatment of symptoms (plasma exchange) • IgG/IgA, or IgM type of paraproteinemic polyneuropathy (plasma exchange) • Myasthenia gravis (plasma exchange) • Renal transplantation, antibody mediated rejection (plasma exchange) • Sickle cell disease: red blood cell exchange for acute stroke • Thrombotic thrombocytopenic purpura (plasma exchange)

Cate

gory

1

• Grade 1A: Strong recommendation, high-quality evidence • Grade 1B: Strong recommendation, moderate quality evidence • Grade 1C: Strong recommendation, low-quality or very low-quality evidence • Grade 2A: Weak recommendation, high quality evidence • Grade 2B: Weak recommendation, moderate quality evidence • Grade 2C: Weak recommendation, low-quality or very low-quality evidence

American Society for Apheresis ( ASFA )

Yt = Y0 e-x

Single-compartment model of plasma exchange

Concentration-time

The initial concentration

Plasma volume replacement in time

Citrate toxicity Allergic reactions Anaphylactoid reactions Infection Deletion of drugs Anemia & hemolysis Hypotermia Hypovolumy

Side effects

سکوتچند خط ...... باالتر از هزار حرف نگفته ما

... به امید روزی که همه مشکالت و تبعیض ها برطرف بشه... باید بخواهیم ... و برایش تالش و ایثار کنیم

احسان مسجدی کارشناس علوم آزمایشگاهی

کپی برداری و استفاده از این پاورپوینت برای!دانشجویان علوم آزمایشگاهی آزاد است

( زکات علم یاد دادنش به دیگرانه )!ولی اگه تونستین از من هم اسمی ببرید

Thanks for your attention!