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Apheresis Services

At Carter BloodCare, we understand the significant role apheresis services play in the treatment of numerous diseases, as well as in the research of leading-edge therapies. That’s precisely why our bloodcare experts serve urgent and routine patient needs where you need us most – at the bedside. In addition to serving as a designated Be The Match® apheresis collection site, we perform leukocyte and platelet depletion, plasma exchange, red cell exchange and cellular therapy collections. If we can help your patients, give us a call.

Carter BloodCare provides mobile adult and pediatric therapeutic apheresis procedures throughout the North Texas area, including Dallas/Ft Worth. This service is provided for hospitals that do not have an apheresis program, but also may serve as a back-up program for hospitals that do provide apheresis services but need assistance for rarely performed procedures or may require back-up in the event that hospital staff are not available to perform the procedures. Carter BloodCare’s therapeutic apheresis staff includes Registered Nurses and/or Hemapheresis Practitioners certified through the American Society of Clinical Pathologists, (ASCP) and apheresis technicians. All are trained in Basic Life Support/CPR (Cardiac Pulmonary Resuscitation).

Due to regulatory considerations, a current, signed contract is required to initiate Apheresis Services. In addition, technical or nursing staff must be credentialed to enter and work in your facility. If these arrangements are not in place, emergency privileges must be established for professional staff performing the procedures.

 
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Therapeutic Apheresis Procedures

 

We serve both urgent and routine patient needs 24/7/365. 

Therapeutic plasma exchange (TPE) for adult and pediatric treatment; including neurology, nephrology, hematology, oncology and patients on extracorporeal circuits. Diseases which may be treated by TPE:

  • Acute inflammatory demyelinating polyradiculoneuropathy (Guillain-Barré syndrome)

  • Acute disseminated encephalomyelitis

  • Antibody mediated rejection of kidney/heart/lung transplantation

  • Anti-glomerular basement membrane disease (Goodpasture’s syndrome)

  • Catastrophic antiphospholipid syndrome

  • Chronic acquired demyelinating polyneuropathies

  • Chronic inflammatory demyelinating polyradiculoneuropathy

  • Cryoglobulinemia

  • Focal segmental glomerulosclerosis

  • Hyperviscosity in hyergammaglobulinemia (as seen with Waldenström’s macroglobulinemia)

  • Lambert-Eaton myasthenic syndrome

  • Multiple Sclerosis

  • Myasthenia gravis

  • Myeloma cast nephropathy

  • Neuromyelitis optical spectrum disorder

  • NMDA receptor antibody encephalitis

  • Thrombotic thrombocytopenic purpura

  • Voltage-gated potassium channel antibody-related diseases

  • Wilson’s disease, fulminant

 
 
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Red cell exchange, primarily for the treatment of sickle cell disease, yet also utilized in the treatment of babesiosis and some cases of severe malaria.

Sickle cell anemia:

  • Pre-operative

  • Refractory pain crisis

  • Acute chest syndrome

  • Priaprism

 
 

Leukocyte depletion is performed for the treatment of Acute Leukemia with severe leukocytosis.

Platelet depletion is offered to remove excess, and dangerously high, platelets in patients who have rare diseases.

Therapeutic phlebotomy is available for the inpatient, with a physician’s order. This on-site service is indicated for hospitalized patients or those with medical conditions that preclude phlebotomy in the donor center.

 
 

Photopheresis is a type of immunotherapy used to treat conditions involving skin, such as cutaneous T cell lymphoma and selected cases of scleroderma, as well as solid organ rejection and graft versus host disease in stem cell transplant patients.

  • Cutaneous T-cell Lymphoma, refractory to other therapies

  • Mycosis Fungoides

  • Sezary Syndrome

  • Chronic Graft Versus Host Disease (hematopoietic stem cell transplant recipient)

  • Cellular allograft rejection (lung or heart)

  • Scleroderma (progressive systemic sclerosis), in some cases

  • Rheumatoid Arthritis

 

Granulocyte collection is indicated for a very limited use.

Pediatric procedures are performed by our nurses at your facility, via a mobile service. We work with your onsite physicians to write the orders. We do not provide onsite medical supervision; however, our physicians with expertise in clinical apheresis are available by phone for consultation. To facilitate this relationship, please contact our administration at 817-412-5158 to establish a contract. We will need to get staff credentialed in your facility if we have not worked there previously. If we already have a working relationship with you, call 972-788-0650 to schedule a procedure.

 
 
 
 
 
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Cellular Therapy Collections

The Clinical Apheresis team at Carter BloodCare provides comprehensive support for hematopoietic progenitor cell (HPC) transplant programs, including the harvest (collection) of HPCs. Processing and storage is available through the Carter BloodCare cellular therapy laboratory, if needed.

 
 
 

Hematopoietic Progenitor Cells (HPCs) from Peripheral Blood

Our team of specialists perform the collection of autologous and allogeneic hematopoietic peripheral blood stem cells (HPC), mononuclear cells, and donor lymphocytes; which can be used in the research of leading-edge therapies. Please note: agreements to process, freeze and store hematopoietic cells must exist between the requesting facility, Carter BloodCare and the donor.

Facilities requesting collection of HPCs from peripheral blood by apheresis should contact the Clinical Apheresis Department. Prior to each HPC collection, the institution must perform administration of G-CSF, catheter placement (when appropriate) and appropriate reports documenting clearance for use. In addition, a Complete Blood Count (CBC) including differential count must be performed before collection.

Carter BloodCare requires a letter of donor suitability, provided by the donor’s physician. The letter must state that the donor has been evaluated by medical history, physical exam and laboratory tests for the risk of apheresis donation. In addition, when appropriate, documentation of a pregnancy assessment on all female donors is required. Physicians must provide written prescription authorizing collection for a specific time period.

Donor Prescreen for HPC Collection

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Carter BloodCare works closely with clients throughout the prescreening process. All donors must undergo a prescreening process within 30 days prior to the start of the first collection. The prescreen process includes evaluation of peripheral access, pregnancy assessment for female donor, and consent for release of medical information. Pregnancy assessments must be performed before hematopoietic growth factor administration or myeloablative therapy of the recipient.

All allogeneic donors must complete the donor questionnaire and undergo routine testing for infectious diseases, ABO/Rh typing, and a red cell antibody screen. The allogeneic donor sample is tested with recipient blood for compatibility.

Collection and Submission of HPCs

HPC collection services are available for autologous and allogeneic, adult and pediatric donors. HPC collection may be performed at an outside facility or a predetermined Carter BloodCare neighborhood donor center.

HPC collection is done by trained personnel using apheresis cell separators. Donation of HPC is generally performed as an outpatient procedure and requires adequate preplanning. Autologous donors generally receive placement of a central venous catheter that can accommodate high volume flow rates, typically either a Quinton or a similar dialysis-type catheter.

For healthy allogeneic donors, central line placement may or may not be necessary depending on the donor’s peripheral access, desired flow rates, and number of procedures required.

 
 
 
 
 
 
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Emergency Privileges

For emergency privileges several items must be completed prior to the procedure. A physician must agree to sponsor the professional staff. A facility administrator must give verbal approval for the procedure to be performed and provide basic billing information.

To initiate emergency privileges:

 
 
 
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Clinical Research Assistance 

Carter BloodCare is an essential partner of both pharma and academia in a number of studies that have taken new products through development, clinical trials, and licensing. We have biologic collection capabilities for research protocol needs.