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Apheresis is a procedure to remove a part of the blood. This procedure may be done to collect cells such as blood-forming (hematopoietic) stem cells.
The collection of stem cells from blood in the veins is also called blood stem cell harvest or peripheral blood stem cell donation.
An apheresis machine takes blood from a vein and separates the blood into parts (plasma, platelets, white blood cells, and red blood cells). The stem cells are removed from the blood. The rest of the blood is returned to the body through a vein. Only a small amount of blood is out of the body at any time. The parts of the blood that are removed are stored for later use.
Stem cells for transplant can come from a donor or the patient.
Before apheresis, a medicine called granulocyte-colony stimulating factor (G-CSF) will be given. G-CSF is a blood growth factor that increases the number of stem cells that circulate in the blood. G-CSF is given as an injection (shot) once a day. The care team will let you know how many shots are needed before apheresis.
Apheresis takes 3 to 8 hours per day. Several sessions may be needed to collect enough of the cells. If more than 1 session is needed, apheresis is usually done once a day. Staff will explain what to expect and answer any questions.
You will be in bed during the apheresis procedure. Wear comfortable, loose-fitting clothing. During the procedure, you can rest, watch a movie, read, or do other quiet activities in bed.
The procedure is usually done with 2 lines (double needle procedure). The medical team will decide the best way to place the lines based on vein size and the number of treatments needed. Types of access include:
The medical team will take steps to reduce the risk of infection. All tubes that touch the blood are sterile (free from germs) and are only used once.
An apheresis nurse will stay at the bedside to monitor for any reactions or problems.
Because you will have tubes attached to the apheresis machine, you will not be able to leave the room once the procedure has started. Portable toilet equipment will be provided if needed.
In addition to the apheresis procedure, other tests or procedures may be needed. These include:
The side effects of apheresis are like those that can happen when people donate whole blood. Any side effects are usually mild and temporary. There is always the risk of rare or unknown side effects.
Side effects of apheresis may include:
Apheresis may cause a lower platelet count or white blood cell count. This decrease is usually small. However, medicines such as NSAIDs or aspirin can increase the risk of bleeding. Do not take these medicines while getting G-CSF or for 2 weeks after stem cell collection unless instructed by your health care provider.
During apheresis, your provider may give a medicine called citrate. This is a blood-thinning medicine. It keeps the blood from clotting in the apheresis machine.
Citrate may cause side effects that include:
The care team may give calcium, either by mouth or by vein, to prevent or treat these reactions.
There is always the risk of very rare or unknown side effects. If you notice any side effects, unusual feelings, or discomfort during apheresis, tell a nurse or a doctor right away.
Please talk to your health care provider or blood donor center staff if you have questions about apheresis.
Reviewed: December 2023