Multicomponent apheresis blood collection in the United States: current status and future directions.

Transfusion medicine in the USA confronts the ongoing challenges posed by a worsening blood supply, regulatory pressure, public pressure for increased safety and cost pressure. Multicomponent apheresis collection (MAC) is a powerful tool for addressing these issues. There are both clinical and operational advantages to MAC. The most important MAC procedures currently performed are platelet and two-red blood cell apheresis. Both procedures are growing in importance to the blood supply as the demand for platelets and red blood cells (RBC) increase. As the demand for safer and more standardized blood components increases, red cell apheresis may possibly become the collection standard.

Cytapheresis: the first 25 years.

In vivo blood cell separator technology was originally developed in response to a perceived need for granulocytes for septic neutropenic patients. This impetus led to the development of a variety of cell separators which, paradoxically, ultimately have found their main applications in pheresis procedures other than granulocyte collection. In vivo blood cell separators are ideal for the removal of large numbers of normal or abnormal hemopoietic cells. Their early use in chronic myeloid leukemia demonstrated that leukapheresis could be used as definitive therapy for the disease. However, most hematological diseases in which the circulating malignant cells can be pheresed off have definitive and cost effective standard of care therapies, and cytapheresis is limited to specific circumstances. This paper reviews therapeutic cytapheresis and summarizes the current status of its limited specific indications.