Therapeutic Apheresis at The Children’s Hospital

The Children’s Hospital is a leader in the field of therapeutic apheresis for a range of disorders affecting pediatric patients, including cancer, blood and autoimmune diseases.

Apheresis means "to remove," and the purpose of therapeutic apheresis is to take away a component of the blood that contributes to an illness.

During apheresis, blood is safely removed from the body and sent to sterile equipment, where it is separated into various components, such as red cells, white cells and plasma. Healthy parts of the blood are then returned to the patient.

Why choose Children’s?

The Children’s Hospital has been developing these pioneering procedures for 25 years and is uniquely equipped to offer comprehensive therapeutic apheresis services to the community. While other facilities may provide apheresis capabilities, we are the only program of its kind in the Denver area dedicated to pediatric patients.

Around the country, services in this specialized discipline are often managed by physicians who don’t specialize in therapeutic apheresis. At Children’s, our center is comprehensive, and we have developed expertise in all therapeutic services.

Conditions we treat

Therapeutic apheresis can help treat conditions such as:

• Cancer, specifically in the collection of stem cells prior to bone marrow transplant

• Blood disorders such as sickle cell disease

• Kidney disease

• Transplant rejection or graft versus host disease

• Autoimmune diseases, such as lupus

Types of therapeutic apheresis

Listed below are some of our more common procedures which can be done on an inpatient or outpatient basis:

Red blood cell exchange

• This process is used in high-risk sickle cell patients to remove sickled red blood cells. It is typically done on a monthly basis to prevent further complications of sickle cell disease, but it may also be done in an emergency for patients in crisis.

• Red blood cell exchange can also be used in patients with erythropoietic protoporphyria (EPP), a rare metabolic disorder.

• Exchanges can be useful in the treatment of overwhelming malaria, although we have not been requested to do this to date.

Therapeutic plasma exchange

• Plasma exchanges can be done for patients experiencing solid organ rejection post-transplant. Our experience has been primarily in heart rejection.

• Plasma exchanges may be done before, during, and after heart transplant surgery for patients who have high antibody levels.

• Certain kidney diseases benefit from plasma exchanges.

• Patients diagnosed with the blood diseases thrombotic thrombocytopenic purpura (TTP) or hemolytic uremic syndrome (HUS) frequently undergo a series of therapeutic plasma exchanges.

Photopheresis

• We use this treatment predominately for graft-versus-host disease affecting the skin.

• This procedure can be used to treat solid organ rejection patients, the majority being in heart rejection.

• Photopheresis was initially developed for the treatment of skin problems associated with cutaneous T-cell lymphoma.

Peripheral blood stem cell collection

• This procedure is used to collect stem cells from the blood stream. The stem cells are then returned to the child after high-dose chemotherapy, providing a rescue to the bone marrow.

White cell depletion

• Patients newly diagnosed with leukemia, and those who have abnormally high white blood cell counts, may undergo this procedure before safely receiving chemotherapy to remove excess white cells.

For more information

If you have questions or want more information about therapeutic apheresis, please call (720) 777-3321.