Citations 3
The apheresis management of patients undergoing transplantation: a concise review
Simmons, Sierra C. , Adamski, Jill , Berg, Mary , Biller, Elizabeth, Fang, Deanna C., Ipe, Tina S. , Shunkwiler, Sara M., Zhao, Yong, Baron, Beverly W. , Pham, Huy P. , AABB, on behalf of the Apheresis Subsection of the, Ipe, Tina S , Pham, Huy P , AABB, on behalf of the Apheresis Subsection of the
Transfusion | January 31, 2019 | Volume: 59 | Issue: 5 | Pages: 1863-1869
Red blood cell exchange in patients with sickle cell disease—indications and management: a review and consensus report by the therapeutic apheresis subsection of the AABB
Biller, Elizabeth, Zhao, Yong, Berg, Mary , Boggio, Lisa , Fang, Deanna C., Koepsell, Scott A. , Music‐Aplenc, Lejla, Treml, Angela , Weiss, John, Wool, Geoffrey D. , Baron, Beverly W. , Baron, Beverly W , Wool, Geoffrey , Capocelli, Kelley E. , Music-Aplenc, Lejla, Pham, Huy P.
Transfusion | September 10, 2018 | Volume: 58 | Issue: 8 | Pages: 1965-1972
BACKGROUNDA prior practice survey revealed variations in the management of patients with sickle cell disease (SCD) and stressed the need for comprehensive guidelines. Here we discuss: 1) common indications for red blood cell exchange (RCE), 2) options for access, 3) how to prepare the red blood cells (RBCs) to be used for RCE, 4) target hemoglobin (Hb) and/or hematocrit (Hct) and HbS level, 5) RBC depletion/RCE, and 6) some complications that may ensue.STUDY DESIGN AND METHODSFifteen physicians actively practicing apheresis from 14 institutions representing different areas within the United States discussed how they manage RCE for patients with SCD.RESULTSSimple transfusion is recommended to treat symptomatic anemia with Hb level of less than 9 g/dL. RCE is indicated to prevent or treat complications arising from the presence of HbS. The most important goals are reduction of HbS while also preventing hyperviscosity. The usual goals are a target HbS level of not more than 30% and Hct level of less than 30%.CONCLUSIONAlthough a consensus as to protocol details may not be possible, there are areas of agreement in the management of these patients, for example, that it is optimal to avoid hyperviscosity and iron overload, that a target Hb S level in the range of 30% is generally desirable, and that RCE as an acute treatment for pain crisis in the absence of other acute or chronic conditions is ordinarily discouraged.
The management of anticoagulation in patients undergoing therapeutic plasma exchange: A concise review
Shunkwiler, Sara M., Wool, Geoffrey D. , Ipe, Tina S. , Fang, Deanna C., Biller, Elizabeth, Treml, Angela , Weiss, John, Baron, Beverly W. , Berg, Mary, AABB, On behalf of the Therapeutic Apheresis Subsection of the, Wool, Geoffrey , Ipe, Tina S , Baron, Beverly W , Pham, Huy P. , AABB, On behalf of the Therapeutic Apheresis Subsection of the
Journal of Clinical Apheresis | October 26, 2017 | Volume: 33 | Issue: 3 | Pages: 371-379
We surveyed multiple apheresis centers represented by the authors for their clinical approach to the management of anticoagulation issues during therapeutic plasma exchange (TPE). We present the results of their practices and a review of the pertinent literature. As plasma is removed during TPE, replacement with all or partial non‐plasma‐containing fluids (eg, 5% albumin) may lead to significant changes in hemostasis. These changes are amplified in patients who are receiving anticoagulation. We discuss various anticoagulants as well as the monitoring and adjustment of anticoagulation before, during, and after TPE. No single guideline can be applied, but rather, patients must be monitored individually, taking into account their often complex clinical conditions and medication profiles.