Chapter 14: Apheresis

Which apheresis method carries the additional risk of returning red blood cells to the wrong individual and yielding the smallest volume of selected blood component?

Manual apheresis

Citrate used as an anticoagulant in apheresis procedures is removed from the body by:

None of the above: (a. the kidneys. c. sweating. b. being metabolized in the liver. )

_________testing is performed on platelet apheresis products to make sure that HIV, WNV, and hepatitis C

Nucleic acid

In plateletpheresis, which blood component is returned to the donor?

Options A and C ( Red blood cells c. White blood cells )

All of the following constitute variables of apheresis procedures except:

blood type

Fatalities that result from therapeutic apheresis have primarily been caused by:

cardiac arrest and arrhythmia

The specific cell product used for treating sepsis is the:

granulocyte

The method in which a specific ligand is bound to an insoluble matrix in a column and plasma is perfused over the column with select removal of pathogenic substance and return of patient's plasma is known as:

immunoadsorption.

A person participating in a serial apheresis program would not

lose more than 25 mL of red blood cells per week

All of the following statements are consistent with photopheresis except:

the patient is given an oral dose of piroxicam, which binds to the RNA of all nucleated cells

Currently, the immunoaffinity column has FDA licensure for treating what disease state?

Idiopathic thrombocytopenic purpura (ITP)

Plasma exchange is most effective when ________ is considered the pathological substance.

IgM

What effect do steroids have on leukapheresis?

Increase the vascular pool of granulocytes

Which of the following terms is defined as the removal of white blood cells with the return of red blood cells, plasma, and platelets?

Leukapheresis

Which patients are at the most risk for platelet refractoriness where they become alloimmunized to HLA antigens on platelets?

Leukemic patients

Erythorcytapheresis is successful in which in which of the following conditions

Malaria

In what circumstance is a plasmapheresis donor rejected from donation?

Serum protein = 5.0 g/dL

A child undergoing apheresis may require CFC to minimize:

extracorporeal volume

All of the following statements are consistent with CFC except:

reinfusion to the patient completes one cycle.

Compatibility testing is required for granulocyte concentration if the red blood cell contamination is greater than:

5 mL

A donor's estimated total blood volume was determined to be 4,500 mL before a plasmapheresis procedure. The extracorporeal blood volume should not exceed:

675 mL

The platelet count of the plateletpheresis donor must be ________ prior to the procedure.

>150 X 10^9 per L

The concentrate obtained from plateletpheresis via a closed system is stored for 5 days at room temperature. What must the pH be at the end of storage?

>=6.0

What other technique is available for neonates with sepsis when apheresis is unavailable?

A buffy coat prepared from a whole blood unit less than 12 hours old

While undergoing plasmapheresis, the donor experienced numbness around his mouth, which is indicative of citrate toxicity. How can this be treated?

Administering exogenous calcium

Fresh frozen plasma (FFP) is not the optimal product for replacement fluids for a therapeutic plasma exchange procedure. For which patient is FFP the optimal product of choice?

All of the above (Patient with liver disease b. Patient with thrombotic thrombocytopenic purpura (TTP) c. Patient scheduled to undergo an invasive procedure )

What variables are necessary to calculate the donor's total blood volume?

All of the above (a. Height c. Sex b. Weight )

When is isolation of PBSCs via apheresis equipment indicated?

All of the above (a. The bone marrow contains malignant cells b. The bone marrow has been irradiated c. The patient cannot tolerate general anesthesia )

What is a disadvantage of choosing fresh frozen plasma for fluid replacement in persons undergoing therapeutic plasmapheresis

All of the above( Citrate toxicity c. ABO incompatibility b. Disease transmission)

How is HES used in apheresis procedures?

As a sedimenting agent to separate white blood cells from red blood cells

Which of the following conditions would necessitate a plasmapheresis procedure?

Barbiturate poisoning

What possible risk exists when hydroxyethyl starch (HES) concentration has exceeded the renal threshold and excretion is retarded?

Blockage of the reticuloendothelial system

Which of the following statements best describes the apheresis concept?

Blood is removed from an individual, anticoagulated, and separated, the desired component is retained, and the remaining portions are returned to the donor/patient

What is an example of a continuous flow centrifugation (CFC) instrument?

COBE Spectra

Which of the following incorporates membrane filtration technology with intermittent flow centrifugation (IFC) apheresis?

COBE Spectra

What is the primary anticoagulant used in pheresis procedures?

Citrate

Photopheresis is effective against what malignant disorder?

Cutaneous T-cell lymphoma

Antiplatelet medications have differing deferral time periods. Which of the following does not match

Feldene—7 days

Which cell type is densest in the white blood cell layer when anticoagulated blood is centrifuged?

Granulocyte

Which immunoadsorbent has an affinity for IgG classes 1, 2, and 4 and their immune complexes?

Staphylococcal protein A

What is the physiological cause of citrate toxicity in cytapheresis procedures?

The anticoagulant in plasma contains citrate, which binds calcium, lowering the body's ionized calcium

Which of the following factors influenced the need for apheresis technology?

The blood component needs of patients on chemotherapy

What is therapeutic plasmapheresis?

The removal of large volumes of patient plasma

Which of the following is not an indication for plasmapheresis?

To decrease iron deposition in tissues in chronically transfused patients

Leukopheresis may be indicated when the white blood cell count exceeds ________.

100,000 per µL

During a plasmapheresis procedure, the red blood cells must be returned within how many hours of phlebotomy?

2 hours

One unit of apheresed platelets should increase the platelet count _________.

20,000 to 60,000 per µL

What does the hematocrit need to be (regardless of gender) for a double red blood cell collection?

40%

Which of the following is an indication for therapeutic apheresis?

Options B and C (b. A pathogenic substance exists in the blood that contributes to a disease process. c. A substance can be more effectively removed by apheresis than by the body's own homeostatic mechanisms)

Plasmapheresis is synonymous with what term

Plasma exchange

What effect does aspirin have on platelets?

Prevents platelet aggregation

What can be done to prevent the development of HLA alloimmunization and platelet refractoriness?

Reduce the number of leukocytes in the platelet product.

What is the definition of apheresis

Separation or removal of a blood component from whole blood

When a sample of whole blood is spun, distinct layers form. What cell line or lines make up the buffy coat?

White blood cells and platelets

A normal healthy donor undergoes a procedure to obtain platelets that will be transfused to a patient is representative of:

component apheresis collection

The removal of red blood cells in a hemapheresis procedure is called:

erythrocytapheresis

The hematopoietic progenitor cells that eventually repopulate the bone marrow and also circulate in the blood are called:

peripheral blood stem cells (PBSC)