Adverse reactions associated with mobile therapeutic apheresis:Analysis of 17,940 procedures

• Published in: Journal of clinical apheresis 2001, Vol.16 (3), p.130-133
• Main Authors: Kiprov, Dobri D., Golden, Patricia, Rohe, Regina, Smith, Sheila, Hofmann, Jan, Hunnicutt, John
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Component Removal - adverse effects; Blood Component Removal - standards; Blood Component Removal - statistics & numerical data; Blood Viscosity; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Catheterization - adverse effects; cytapheresis; Databases, Factual; Guillain-Barre Syndrome - complications; Guillain-Barre Syndrome - therapy; hemapheresis; Hematologic Diseases - complications; Hematologic Diseases - therapy; Humans; Medical sciences; Mobile Health Units - standards; Mobile Health Units - statistics & numerical data; Myasthenia Gravis - complications; Myasthenia Gravis - therapy; plasmapheresis; Point-of-Care Systems - standards; Point-of-Care Systems - statistics & numerical data; Polyneuropathies - complications; Polyneuropathies - therapy; Purpura, Thrombotic Thrombocytopenic - complications; Purpura, Thrombotic Thrombocytopenic - therapy; side effects; Transfusions. Complications. Transfusion reactions. Cell and gene therapy
• ISSN: 0733-2459; 1098-1101
• DOI: 10.1002/jca.1024

In order to evaluate the nature and frequency of adverse reactions associated with Therapeutic Apheresis (TA), database information from two large mobile apheresis services was analyzed. A total of 17,940 procedures performed on 3,583 patients were studied using an Access Database. Seventy percent (12,558) of the procedures were performed on a Fresenius AS104 blood cell separator and 30% (5,382) were performed on a COBE Spectra. The five most commonly treated diseases were Guillain‐Barre Syndrome (25%), thrombotic thrombocytopenic purpura (20%), myasthenia gravis (18%), the hyperviscosity syndrome (12%), and chronic inflammatory demyelinating polyneuropathy (9%). All patients received calcium gluconate supplement during the procedures. Cardiac monitoring was used during 80% of the procedures and blood pressure monitoring was used during all procedures. All procedures were supervised by a physician. Both apheresis services fully comply with the ASFA Guidelines for Therapeutic Apheresis Providers. Adverse reactions occurred in 3.9% of all procedures. The following adverse reactions were documented: reactions related to ACD toxicity (3%), vasovagal reactions (0.5%), vascular access related complications (0.15%), reactions related to FFP (0.12%), hepatitis B from FFP (0.06%), arrhythmias (0.01%), hemolysis due to inappropriate dilution of 25% albumin (0.01%), and one death (from underlying disease) during a TA procedure (0.006%). These data demonstrate that therapeutic apheresis is associated with a low rate of side effects when performed by well‐trained and certified nurses under the direction of experienced physicians, even in the diverse setting of large mobile therapeutic apheresis programs. J Clin Apheresis 16:130–133, 2001. © 2001 Wiley‐Liss, Inc.