Apheresis Unit
Apheresis and Infusion Services
The Apheresis/ Infusion Unit, located on 3 White/Ravdin performs approximately 5,000 procedures per year on both inpatients and outpatients who suffer from a wide variety of disorders, such as hematologic, hemostatic, immunologic, oncologic, neurologic, and genetic, including leukemia and lymphoma, multiple myeloma, familial hypercholesterolemia, thalassemia, sickle cell disease, multiple sclerosis, and myasthenia gravis.
Description
Through the use of apheresis technology, apheresis specialists separate patient blood into its cellular and liquid fractions and, depending on the particular procedure, can either cleanse an individual's blood of harmful substance or harvest cells for the purpose of treating a disease. For example, by removing plasma ("plasma exchange") the Apheresis Unit treats a large number of antibody-mediated autoimmune diseases such as myasthenia gravis (a neurological disorder), Goodpasture's syndrome (a kidney disorder), and TTP (a clotting disorder). Through the collection of peripheral blood hematopoietic stem cells or mononuclear cells, apheresis can provide cellular material for performing hematopoietic stem cell transplants or for manufacturing novel cellular therapies chimeric antigen T cells (CAR-T), respectively.
Other procedures include removing elevated levels of white cells ("leukapheresis") to prevent neurological, cardiac, and pulmonary damage resulting from impeded blood flow that can be experienced by newly diagnosed leukemic patients (hyperleukocytic syndrome) or removing and exchanging patient red blood cells for donor red blood cells ("erythrocytapheresis") to prevent or treat pain and morbidity experienced by patients with sickle cell disease.
The Unit also combines apheresis technology with specialized adsorption columns to selectively remove specific disease-causing substances from an individual's circulation. For example, “lipoprotein apheresis” refers to the specific removal of LDL-cholesterol from the plasma of those afflicted with chronically elevated cholesterol levels unresponsive to lipid-lowering medications.
Engineered cellular therapy was pioneered at Penn Medicine and the cells collected by apheresis, manufactured into CAR-T cells can be used to treat liquid tumors such as leukemia, lymphoma, and multiple myeloma as well as clinical trials for solid tumors such as glioblastoma, prostate, ovarian, and others.
In addition to apheresis procedures, the unit is also responsible for the collection of patient red cells for use during or after surgery ("autologous blood"); performing therapeutic phlebotomies on patients with dangerously high red cell counts (polycythemia) or iron levels (hemachromatosis); outpatient transfusions of red cells, platelets, and/or plasma; and outpatient infusions of manufactured cellular therapies.
The Apheresis unit is accredited by the AABB, CAP, and FACT.
Faculty and Staff
Dr. Nicole Aqui serves as Director of Apheresis Services and Dr. Don Siegel serves as the unit’s medical director. Leah Irwin, RN, MSN, CRNP is the Nurse Manager. Additional attending physician supervision is provided by Drs. Andrew Fesnak, Vijay Bhoj, Taku Kambayashi, and Una O’Doherty. The Apheresis Unit is open Monday to Friday, 8:00 AM to 4:00 PM. After-hours care for emergencies can be obtained by contacting the Pathology resident on call.
