Performed at Morris Cancer Clinic

Outpatient apheresis is on the second floor of the Morris Cancer Center Clinic. Enter the Morris Clinic Building on the first floor, take the Entry Elevator to the second floor. Turn right off the elevator, then right again, down the long hallway to the check in area for the Treatment Center. You will be checked in there and escorted to Outpatient Apheresis.

What is Apheresis?

Apheresis is a procedure to withdraw blood from a person and separate it to remove a specific type of cell. This is done with a machine known as a cell separator. This procedure is used to treat a variety of diseases. It can also be used to collect certain blood products for treating patients and for research studies.

How to Prepare

Two days before:
Eat or drink calcium products such as milk, cheese, ice cream, yogurt, or a calcium supplement. Calcium is lost during the procedure so it will help you to have extra calcium in your body.

The morning of:
If allowed, you are encouraged to eat a meal a couple of hours before your treatment. However, avoid drinking large amounts of fluids in the couple hours before the procedure as you won’t be able to get up to go to the bathroom. Wear comfortable clothes and a short-sleeved shirt.

Just before:
A visit to the bathroom just before starting the procedure is encouraged.

What to Expect

Apheresis can be performed in either the patient's hospital room or in the Apheresis Outpatient department. A specially trained nurse will monitor the patient and the machine throughout the procedure. An apheresis procedure usually takes between one and four hours.

During the procedure, you will be connected to the cell separator machine by two tubes. One will carry your whole blood to the machine, where the specific cell type will be removed. The second tube will return the remaining blood to you. If you have a double lumen central venous catheter available, that can be used for the procedure. Otherwise, you will have intravenous (IV) catheters inserted into both arms. There may be some minor discomfort at the needle sites.

When the procedure is finished, you will be disconnected from the machine. If you had IV catheters in your arms, these will be removed and dressings applied.

How often apheresis is done depends on the reason for the procedure. If it is being done as a treatment for chronic high levels of certain blood cells or plasma proteins, it may be done on a regular basis. If it is being done to collect blood cells for a treatment such as stem cell transplantation, it may be done only once or twice.

Possible Side Effects

The procedure may cause a number of side effects. Some of the more common side effects you may experience during the procedure are: tingling of the lips, itching, hives, low blood pressure, bruising and swelling at the needle sites, fatigue, lightheadedness, and chilling.

Some less common side effects are: nausea, vomiting, diarrhea, headache, loss of red cells, rapid or slow pulse, and puffiness. Whenever the skin is broken, there is a possibility of infection. This could occur at the needle site and would be recognized by redness and tenderness at the needle site and fever. Tell your nurse should you experience any of the above symptoms. However, once the procedure begins, there is usually minimal discomfort.

After Procedure Instructions

Have someone available to drive you home .after the procedure.

• You will need to rest, drink extra fluids (non-alcoholic), and eat well.
• Leave the bandages on your arms for at least two hours.
• Keep the sites dry and avoid exercise or heavy lifting for the rest of the day.
• Lie down and elevate your legs should you become dizzy.
• If the site begins to bleed, apply pressure with a clean cloth and raise your arm until the bleeding stops.
• If a bruise occurs, apply ice for several minutes at a time for the first 24 hours and occasional warm compresses afterwards until soreness has resolved.
• Should any of the above symptoms not improve using the information given, call your physician for further instructions.

If you have any questions regarding your apheresis procedure, please call the Duke Apheresis office at 919-684-6663, Monday-Friday from 8 a.m. to 4:30 p.m.

This article is intended as a resource for patients receiving their cancer care at Duke University Hospital or Duke Clinic. It is not intended to substitute for medical advice from your healthcare team. If your doctor’s instructions differ from the information in this article, please talk with your doctor before making any changes.

Source: Cancer Patient Education Program, approved: Duke PEC