Prevention and Management of Apheresis Complications
Apheresis techniques are generally safe, and serious adverse events rarely occur. However, apheresis procedures cause major physiologic changes in donors and patients, including hypocalcemia due to citrate infusion, hemodynamic changes associated with fluid shifts, and/or depletion of cellular and plasma components. Moreover, adverse events may be unrelated to the apheresis procedure itself (e.g., hematomas and/or infections from line). In general, these adverse events can be system or local; they can also be differentiated based on the etiology, such as immunologic (e.g., side effects from admission of blood components and of ethylene oxide) and non-immunologic events (e.g., hypovolemia, hypocalcemia). Besides this, the complications can be acute (i.e., during the apheresis procedure) but can also happen hours, days, or maybe even years after apheresis procedure. Measures can be taken to avoid complications during apheresis to identify population at risks for these complications, for example, special considerations for children for whom therapeutic apheresis procedures are indicated to avoid complications.