Therapeutic apheresis

Therapeutic apheresis services are a consultative service provided to hospitals under a contractual agreement. ImpactLife is licensed by the US Food and Drug Administration and accredited by AABB.

ImpactLife's Patient Services team of physicians and specialty trained nurses provides safe, effective care throughout the procedure. Support is available 24 hours a day, seven days a week.

ImpactLife provides training to hospital staff on the process, requirements, and documentation related to the procedures. CE credits are available.

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WHEN IS Therapeutic apheresis USED?

Therapeutic apheresis is effective in treating the symptoms of a number of diseases where the plasma contains a known pathologic component. By removing the symptom-causing substances from the plasma, patients experience symptom relief.

Ideally, the plasma exchange procedure will remove these substances faster than the body can make them. For example, in some autoimmune disorders, therapeutic apheresis is used to remove the existing harmful antibodies while drugs suppress their future production.

There are numerous indications for TA. Indications have been categorized by the American Society for Apheresis (ASFA) and AABB after review of published studies based on outcome data.

We recommend that the technique be limited to situations of expected major benefit. Less established uses of therapeutic apheresis are considered upon consultation and discussion with someone from the ImpactLife Medical Team.

Established Indications for Therapeutic Apheresis
PLASMA EXCHANGE
Chronic Inflammatory Demyelinating Polyneuropathy	Hyperviscosity Syndrome	Thrombotic Thromboctyopenic Purpura
Lambert-Eaton Myasthenic Syndrome	Multiple Myeloma	Waldenström's Macroglobulinemia
Goodpasture's Syndrome (Anti-GBM disease)	Myasthenia Gravis	Kidney Transplant Rejection
Guillain-Barré Syndrome	Post-transfusion Purpura	Drug Overdose of Protein Bound Drugs
CELL DEPLETION
Leukocytosis with Leukostasis	Severe Thrombocytosis with Compromised Circulation
RED CELL EXCHANGE
Sickle Cell Anemia	Malaria or Babesiosis

ORDERING THERAPEUTIC APHERESIS

To request a therapeutic apheresis procedure, call 563-349-1677 and provide the following information:

• Diagnosis
• Symptoms
• Date of birth, weight, height
• Start date & frequency of treatment
• Current medications
• Pertinent lab and imaging results supporting the treatment indication, as well as CBC, BCP
• Ordering physician email and phone number
• Other medical conditions (e.g. heart disease, kidney disease)
• Vascular access to be used 
• Patient demographic information & location of treatment

Once patient needs and urgency have been determined and the procedure has been scheduled, the ImpactLife team will be dispatched to the hospital.

The patient is closely monitored throughout the procedure for adverse effects and a clinical record is left with nurse/physician. In the event of a change in clinical status, the patient's nurse and/or physician is immediately notified for collaborative care.

VASCULAR ACCESS

No procedures can be scheduled without understanding what venous access will be available. Peripheral access must be equivalent to bilateral 17 gauge thin-walled IV access to allow acceptable flow rates. Patients who do not have adequate peripheral access should have a Quinton-type dual lumen central line. PICC lines and Groshong catheters are not appropriate for use with therapeutic apheresis procedures. Central access will generally need to be sufficient to support flows similar to those required for hemodialysis. ImpactLife will ask that your patient's access is capable to handle the procedure and if not, to ensure access prior to ImpactLife arriving for the procedure.