Risks and safety practices in hemapheresis procedures

In hemapheresis procedures carried out for the collection of blood components, healthy donors are subjected to the old familiar risks of blood donation, plus those specifically relating to the use of blood cell separators and to the selective extraction (and loss to the donor) of individual blood components. The responsible physician must actively control these procedures, from the point of view of effective component collection and protection of the donor from undesirable procedural reactions, as well as potentially dangerous blood component depletion. The application of similar hemapheretic techniques to patients is quite a different matter. Patients do not have the same tolerance of blood manipulative techniques as do healthy donors. Furthermore, therapeutic component depletions are usually much more radical than the procedures applied to donors. The physician responsible for such therapeutic operations must play an active, consultative role with the clinical physician in discussing the likely efficacy of such treatment, the identification of risk factors, obtaining informed consent, deciding on a schedule of operations, replacement solutions, supplementary therapy, and overall supervision of procedures.