CLINICAL SERVICES

PERIOPERATIVE BLOOD SALVAGE

Perioperative Blood Salvage is the collection and reinfusion of blood lost during and immediately after surgery. The blood from the surgical field is recovered, mixed with an anticoagulant and pumped through a cell salvage machine where it is centrifuged and washed. The resulting red blood cells are then pumped into a transfer bag. The blood may be reinfused to the patient immediately or at a later time.

The use of perioperative blood salvage can reduce or eliminate the patient’s need for allogeneic blood transfusion and can be an alternative or complement to autologous blood donation. Patients requiring two or more units of blood during surgery can benefit from this program. Perioperative salvage may be used for patients undergoing vascular, orthopedic, urologic, gynecological and cardiac surgery. Other procedures where perioperative salvage may be useful are splenectomy and liver resection as well as organ transplantation.

Contraindications

Since no blood filtering or blood washing system can completely eliminate bacteria, infection can occur. Bacterial contamination of salvaged blood can occur in procedures with spilled intestinal contents, bacterial peritonitis, abscesses, or osteomyelitis.

Malignant cells in salvaged blood cannot be completely removed by washing or filtration. There is a theoretical risk of metastases when transfusing salvaged blood during surgery for malignancy.

Perioperative blood salvage programs operate under AABB and CAP guidelines. Go to www.aabb.org for more information.

THERAPEUTIC (CLINICAL) APHERESIS SERVICES

United Blood Services provides therapeutic apheresis services at selected blood center locations or, by arrangement, at the hospital for the convenience and safety of the patient.

The theoretical basis for therapeutic apheresis is to reduce the patient’s load of a pathologic substance to levels that will allow clinical improvement. The term “therapeutic apheresis” is used for the general procedure and the term “therapeutic plasma exchange” (TPE) is used for procedures in which the goal is to remove plasma containing the pathologic substance and replace it with normal plasma or a starch- or albumin-based crystalloid or colloid solution.

Types and Indications

Plasmapheresis – Therapeutic plasma exchange is indicated for several hematologic and neurologic conditions. Conditions such as Serum Hyperviscosity Syndrome, Thrombotic Thrombocytopenic Purpura/Hemolytic-Uremic Syndrome (TTP/HUS), Myasthenia Gravis and Acute Guillain-Barre Syndrome have been treated with TPE procedures.

Leukapheresis – Therapeutic white cell depletion has been used to treat dramatically elevated white cell counts that can occur in acute leukemia.

Erythrocytapheresis – Therapeutic red cell removal and exchange may be used to treat complications of Sickle Cell Disease.

Plateletpheresis – Platelet depletion can be used for Thrombocythemia in symptomatic patients with platelet counts above 1,000,000/uL.

Staphylococcal Protein A (SPA) Immunoadsorption – SPA immunoadsorption is approved by the FDA for treatment of acute and chronic immune thrombocytopenic purpura and adults with rheumatoid arthritis unresponsive to disease-modifying antirheumatic drugs. In this procedure, plasma from the patient is passed through a column containing protein A, which will bind IgG and other immune complexes. The plasma is then returned to the patient.

Exceptional Service

United Blood Services’ mobile therapeutic apheresis program offers the following benefits:

• No need to transfer patients; our staff will bring the service to the hospital
• Highly competent nursing and apheresis technicians
• Access to United Blood Services’ medical staff physicians
• Consistent and current standard operating procedures
• Quality assurance that is documented and routinely audited
• Well-maintained and calibrated equipment
• On-demand service, 24 hours/day, 7 days/week

To schedule

The patient’s physician:

• Identifies candidates for a therapeutic procedure
• Orders appropriate procedure and frequency
• Completes applicable section of request form Attending Physicians Request for Therapeutic Apheresis (BS 702).
• Discuss the Therapeutic Apheresis Informed Consent (BS 707A) with the patient and obtain signature.

The physician’s office/hospital:

• Contacts the blood center to schedule the procedure(s)
• Faxes completed Attending Physicians Request for Therapeutic Apheresis (BS 702), and the Therapeutic Apheresis Informed Consent (BS 707A) to the blood center.

United Blood Services:

• Reviews order for completeness
• Contacts medical director as needed
• Performs procedure(s)
• Has medical director review patient chart.

How to Order:

Contact your United Blood Services center to find out more about options for therapeutic apheresis. To find the center nearest you click here.

STEM CELL PROCESSING LABORATORY

Blood Systems’ Stem Cell Processing Section is a high complexity laboratory committed to providing its customers quality Hematopoietic Progenitor Cell (HPC) processing, storage and shipment. It is located within the existing facilities of Blood Systems Laboratories in Tempe, AZ.

The facility is divided into the following functional areas to ensure separation of activities and thus reduce the risk of product mix-up and cross contamination:

• Gowning Room
• Laboratory Room
• Storage Area
• Freezer Room

The Laboratory is accredited by FAHCT and AABB (see accreditation) to process both autologous and allogeneic HPC products.

Description of Services

The Stem Cell Processing Laboratory has a wide variety of validated procedures in place including:

• Volume reduction and Red Blood Cell (RBC) depletion for both apheresis stem cell collections (HPC-A) and bone marrow (BM) collections
• Freezing HPC-A and BM
• Cord Blood (CB) thaw and wash
• Short term (refrigeration) and long term storage (liquid nitrogen vapor phase)
• Shipping Stem Cell products throughout the US.
• Donor, product and patient testing (infectious diseases and product cell enumerations by flow cytometry)

For more information about stem cell processing please contact Blood Systems Laboratories at 866-342-4275 extension 7103.