Apheresis

Apheresis

Basic content

Apheresis (Plateletpheresis or platelet-richplasmapheresis) is whole blood platelets separated from the preparation of platelet-rich plasma (Platelet-richplasma, PRP) or platelet concentrates, is an important technology component transfusion. Early 1990s, apheresis been ported to bypass (Cardiopulmonarybypass, CPB) in cardiac surgery, its significant protective role of the blood is attracting more and more attention.

Basic equipment and methods

Apheresis separation methond is by machine according to the proportion of differences from each other. The basic configuration includes: blood collection pipe, centrifugal separation cup, blood component collection bag and the machine hardware and so on. Apheresis operations;

Application of cardiopulmonary bypass surgery, anesthesia after the success of central venous catheter blood, venous catheter body that is directly connected to the open end of the pipe to the machine to collect blood, anticoagulant citrate phosphate dextrose solution (Citratephosphatedextrose, CPD) mixed with the blood in the pipe, into the machine’s blood was centrifuged out of PRP.

Bled while peripherally complementary crystal / colloid to maintain hemodynamic stability. Also in central venous catheter directly before taking arm vein puncture blood. Bloodletting speed should be controlled at 50 ~ 100ml per minute.

Based on differences in the performance of sub-machine two to three cycles to collect a sufficient number of platelets. The remaining blood components in circulation after the end of each round immediately transferred back to the patient, to ensure the normal oxygen carrying capacity and hemodynamically stable patient’s blood. Entire separation and extraction process before the end of CPB heparin. CPB end, protamine completely neutralize heparin after PRP promptly returned to the patient, pay attention to infusion rate to prevent adverse reactions.

The process of separation and extraction operations should be strictly aseptic, PRP prepared and stored at room temperature, light shake to prevent platelet aggregation. Check PRP platelet count to estimate the total number of separate save platelets, fibrinogen and other clotting factors to detect and total protein content.

It should also be monitoring of platelet activation markers [1] The α- granule membrane glycoprotein 140 (GMP-140), platelet factor 4 (PF4), etc., in order to speculate on the separation of the platelet preservation process