Therapeutic Apheresis Indications

Plasma exchange and cytapheresis in hematology

Written by: Saygı Hospital Health Guide Editorial Board

Last updated: June 20, 2026

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Hematoloji department. Book Appointment →

What is Therapeutic Apheresis Indications?

Therapeutic apheresis is a procedure that separates blood components and selectively removes pathogenic substances. Plasma exchange replaces patient plasma with donor plasma or albumin. Cytapheresis selectively removes leukocytes, red cells or platelets. Procedures are guided by American Society for Apheresis category recommendations.

Hematological category one indications include thrombotic thrombocytopenic purpura with daily plasma exchange, hyperviscosity syndrome with symptomatic Waldenstrom or myeloma and cryoglobulinemia with severe organ involvement. Leukapheresis is used in symptomatic hyperleukocytosis to reduce blast burden before chemotherapy.

Procedures require central venous access usually with double lumen apheresis catheter, careful anticoagulation with citrate or heparin, and monitoring for hypocalcaemia, allergic reactions and volume shifts. Hospital based apheresis units with experienced staff are preferred to ensure safety.

Symptoms

Procedure not a disease symptom

Citrate related perioral tingling

Hypotension during procedure

Allergic reactions to plasma replacement

Catheter related infection rare

Risk Factors

Severe hemodynamic instability

Active uncontrolled infection

Inability to tolerate volume shifts

Severe coagulopathy without correction

Lack of vascular access

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

When TTP is suspected as emergency
When hyperviscosity is symptomatic
When cryoglobulinemia damages organs
When hyperleukocytosis is symptomatic

Treatment Methods

Daily plasma exchange in TTP until response

Plasma exchange for symptomatic hyperviscosity

Plasma exchange in severe cryoglobulinemia

Leukapheresis for symptomatic hyperleukocytosis

Erythrocytapheresis in severe sickle crisis

Calcium and volume monitoring during procedure

Which Department to Visit?

You can visit our Hematoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Hematoloji Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Book Appointment Contact Us

Related Health Topics

Other articles from the same department you may want to explore.

Anaemia

Dahiliye (İç Hastalıkları)

Anaemia is a low haemoglobin level that reduces oxygen delivery, causing fatigue, pallor, and shortness of breath. It is not a disease itself but a sign of many underlying conditions. Most cases are correctable with appropriate diagnosis and treatment.

Iron Deficiency Anaemia

Dahiliye (İç Hastalıkları)

Iron deficiency anaemia develops when dietary intake, absorption, or losses create an iron shortfall, most often affecting women and children. Identifying the underlying cause is the core of management, alongside iron replacement.

Vitamin B12 Deficiency

Dahiliye (İç Hastalıkları)

Vitamin B12 deficiency can cause megaloblastic anaemia, neurological symptoms, and cognitive impairment. Early treatment with intramuscular or oral B12 largely prevents irreversible complications.

Hypertension (High Blood Pressure) Management

Dahiliye (İç Hastalıkları)

Hypertension is often called the silent killer because it progresses symptom-free for years and can damage the heart, brain, kidneys, and eyes. Regular monitoring, lifestyle change, and evidence-based drug therapy dramatically reduce cardiovascular risk.

Chronic Kidney Disease

Dahiliye (İç Hastalıkları)

Chronic kidney disease is one of the most common complications of chronic conditions such as diabetes and hypertension, and can be silent in its early stages.

Hepatitis B (HBV)

Dahiliye (İç Hastalıkları)

Hepatitis B is a DNA virus infection causing acute and chronic hepatitis with risk of cirrhosis and hepatocellular carcinoma; diagnosis integrates HBsAg, HBeAg, anti-HBc, and HBV DNA with management based on disease phase using nucleos(t)ide analogues (entecavir, tenofovir) and universal infant vaccination.

Hepatitis C (HCV)

Dahiliye (İç Hastalıkları)

Hepatitis C is an RNA virus causing chronic hepatitis that may progress to cirrhosis and hepatocellular carcinoma; modern direct-acting antiviral (DAA) pangenotypic regimens (sofosbuvir/velpatasvir, glecaprevir/pibrentasvir) achieve sustained virologic response over 95% in 8–12 weeks with universal adult screening and cure for nearly all patients.

Fatty Liver Disease

Dahiliye (İç Hastalıkları)

Non-alcoholic fatty liver disease (NAFLD) is closely related to obesity and metabolic syndrome and is largely reversible with early treatment.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.