Disinfect, insert the cannula, pull out the cannula, dress the wound. The blue pressure cuff is controlled by the platelet<unk>  machine in newer models. There are numerous types of<unk> . Donation Blood taken from a healthy donor can be separated into its component parts during blood donation, where the needed component is collected and the unharvested components are returned to the donor. Fluid replacement is usually not needed in this type of collection. In many countries,<unk>  donors can donate blood more often than those donating whole blood. There are several categories of component collections: * Plasmapheresis – blood plasma. Plasmapheresis is useful in collecting FFP (fresh frozen plasma) of a particular ABO group. Commercial uses aside from FFP for this procedure include immunoglobulin products, plasma derivatives, and collection of rare WBC and RBC antibodies. * Erythrocytapheresis – red blood cells. Erythrocytapheresis is the separation of erythrocytes from whole blood. It is most commonly accomplished using the method of centrifugal sedimentation. This process is used for red blood cell diseases such as sickle cell crises or severe malaria. The automated red blood cell collection procedure for donating erythrocytes is referred to as 'Double Reds' or 'Double Red Cell<unk> .' * Plateletpheresis (thrombapheresis, thrombocytapheresis) – blood platelets. Plateletpheresis is the collection of platelets by<unk>  while returning the RBCs, WBCs, and component plasma. The yield is normally the equivalent of between six and ten random platelet concentrates. Quality control demands the platelets from<unk>  be equal to or greater than 3.0 × 1011 in number and have a pH of equal to or greater than 6.2 in 90% of the products tested and must be used within five days. * Leukapheresis – leukocytes (white blood cells). Leukopheresis is the removal of PMNs, basophils, eosinophils for transfusion into patients whose PMNs are ineffective or where traditional therapy has failed. There is limited data to suggest the benefit of granulocyte transfusion. The complications of this procedure are the difficulty in collection and short shelf life (24 hours at 20 to 24 °C). Since the "buffy coat" layer sits directly atop the RBC layer, HES, a sedimenting agent, is employed to improve yield while minimizing RBC collection. Quality control demands the resultant concentrate be 1.0 × 1010 granulocytes in 75% of the units tested and that the product be irradiated to avoid graft-versus-host disease (inactivate lymphocytes). Irradiation does not affect PMN function. Since there is usually a small amount of RBCs collected, ABO compatibility should be employed when feasible. * Stem cell harvesting – circulating bone marrow cells are harvested to use in bone marrow transplantation. Donor safety * Single use kits –<unk>  is done using single-use kits, so there is no risk of infection from blood-contaminated tubing or centrifuge. Blood does not contact the device and during the separation, blood does not exit the kit. * Reinfusion – At the end of the procedure, the remaining blood in the kit is given back to the donor with a process called 'reinfusion'. * Immune system effects – "the immediate decreases in blood lymphocyte counts and serum immunoglobulin concentrations are of slight to moderate degree and are without known adverse effects. Less information is available regarding long-term alterations of the immune system". Kit problems Two<unk>  kit recalls were: * Baxter Healthcare Corporation (2005), in which "pinhole leaks were observed at the two-omega end of the umbilicus (multilumen tubing), causing a blood leak." * Fenwal Incorporated (2007), in which there were "two instances where the anticoagulant citrate dextrose (ACD) and saline lines were reversed in the assembly process. The reversed line connections may not be visually apparent in the monitor box, and could result in excessive ACD infusion and severe injury, including death, to the donor." Donor selection People who do not use a drug that may prevent blood donation, who do not have the risk of the carrier of a disease, and who have suitable vascular structure may be<unk>  donors. For<unk>  platelet donation the donor's pre platelet count should be above 150 x 10^9/L. For<unk>  plasma donation, the donor's total protein level should be greater than 60 g/L. For double red cell<unk> , donors of either gender require a minimum hemoglobin level of 14.0 g/dl. Plasticizer exposure<unk>  uses plastics and tubing, which come into contact with the blood. The plastics are made of PVC in addition to additives such as a plasticizer, often DEHP. DEHP leaches from the plastic into the blood, and people have begun to study the possible effects of this leached DEHP on donors as well as transfusion recipients. * "current risk or preventive limit values for DEHP such as the RfD of the US EPA (20 μg/kg/day) and the TDI of the European Union (20–48 μg/kg/day) can be exceeded on the day of the plateletpheresis. ... Especially women in their reproductive age need to be protected from DEHP exposures exceeding the above mentioned preventive limit values." * "Commercial plateletpheresis disposables release considerable amounts of DEHP during the<unk>  procedure, but the total dose of DEHP retained by the donor is within the normal range of DEHP exposure of the general population." * The Baxter company manufactured blood bags without DEHP, but there was little demand for the product in the marketplace * "Mean DEHP doses for both plateletpheresis techniques (18.1 and 32.3 μg/kg/day) were close to or exceeded the reference dose (RfD) of the US EPA and tolerable daily intake (TDI) value of the EU on the day of the<unk> . Therefore, margins of safety might be insufficient to protect especially young men and women in their reproductive age from effects on reproductivity. At present, discontinuous-flow devices should be preferred to avert conceivable health risks from plateletpheresis donors. Strategies to avoid DEHP exposure of donors during<unk>  need to be developed." Therapy The assembly (A–D), operation (E) and disassembly (F) of the platelet<unk>  machine, which can be configured to separate other components as well The various<unk>  techniques may be used whenever the removed constituent is causing severe symptoms of disease. Generally,<unk>  has to be performed fairly often, and is an invasive process. It is therefore only employed if other means to control a particular disease have failed, or the symptoms are of such a nature that waiting for medication to become effective would cause suffering or risk of complications. * Plasma exchange – removal of the liquid portion of blood to remove harmful substances. The plasma is replaced with a replacement solution. * LDL<unk>  – removal of low density lipoprotein in patients with familial hypercholesterolemia. * Photopheresis – used to treat graft-versus-host disease, cutaneous T-cell lymphoma, and rejection in heart transplantation. * Immunoadsorbtion with Staphylococcal protein A-agarose column – removal of allo- and autoantibodies (in autoimmune diseases, transplant rejection, hemophilia) by directing plasma through protein A-agarose columns. Protein A is a cell wall component produced by several strains of Staphylococcus aureus which binds to the Fc region of IgG. * Leukocytapheresis – removal of malignant white blood cells in people with leukemia and very high white blood cell counts causing symptoms. * Erythrocytapheresis – removal of erythrocytes (red blood cells) in people with iron overload as a result of Hereditary haemochromatosis or transfusional iron overload * Thrombocytapheresis – removal of platelets in people with symptoms from extreme elevations in platelet count such as those with essential thrombocythemia or polycythemia vera.
Apheresis
Photopheresis
Dialysis
Aquapheresis
Rheopheresis
Iridodialysis
Plasmapheresis
Hemoperfusion