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[How to implement a complete apheresis program within a hemodialysis unit]
Jocelyne Maurizi-Balzan1, Thomas Jouve1, Hamza Naciri-Bennani1
1Service de Néphrologie Hémodialyse Aphérèses et Transplantation rénale, CHU de Grenoble-Alpes, CS 10217, 38043 Grenoble cedex 09, France.
Nephrologie & Therapeutique
|October 6, 2019
Summary
Establishing an apheresis platform in a hemodialysis facility offers integrated care for complex conditions. This approach facilitates tandem procedures and effective management of apheresis side effects, improving patient outcomes.
Area of Science:
- Nephrology and Hematology
- Extracorporeal Therapies
Background:
- Apheresis techniques can be performed in blood-bank or hemodialysis (HD) facilities.
- Integrating apheresis within HD facilities offers advantages due to shared extracorporeal circuits and the possibility of tandem procedures.
Purpose of the Study:
- To describe the setup and outcomes of an apheresis platform within a hospital setting.
- To highlight the benefits of performing apheresis in a hemodialysis facility.
Main Methods:
- Established an apheresis platform adhering to health recommendations.
- Developed protocols for various pathologies and patient monitoring.
- Performed therapeutic plasma exchange, double-filtration plasmapheresis, rheopheresis, LDL-apheresis, and immunoadsorption.
Main Results:
- Conducted 1845 apheresis sessions across 134 patients over two years.
- Successfully managed apheresis-related side effects like hypotension, fluid overload, and hypocalcemia.
- Achieved patient outcomes comparable to literature for kidney transplantation and other conditions.
Conclusions:
- An integrated apheresis platform in a hemodialysis facility is feasible and effective.
- This model facilitates interdisciplinary collaboration and specialized training.
- The program is expanding into a center for apheresis technique training.
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