History and tradition

Structure
 - Clinical hematology department
 - Laboratory department "Diagnostics of blood diseases"
 - Transfusion hematology department
 - Administrative department
 - Quality assurance and quality control of blood and blood products laboratory
 - Department for preparation of treatment and diagnostic plasma products
 - Organization and providing of information department of NCHT

Activities
 - Diagnostics
 - Curative activities
 - Preparation of blood products
 - Science & research
 - Clinical trials
 - Educational activities

Staff
 - Clinical hematology department
 - Laboratory department "Diagnostics of blood diseases"
 - Transfusion hematology department
 - Administrative department
 - Quality assurance and quality control of blood and blood products laboratory
 - Department for preparation of treatment and diagnostic plasma products
 - Organization and providing of information department of NCHT

Contact us		  

 

THERAPEUTIC APHERESIS UNIT

 

            The Therapeutic apheresis unit, which is a part of Clinical Hematology department, has been established since more than twenty years. It is unique for our country. We perform therapeutic apheresis procedures, including plasmapheresis /PF/ or plasma exchange /PE/ and cytapheresis /different kinds, depending on the withdrawn blood cell population /.

These procedures are carried out by Nina Vasileva, MD, specialist of Internal Medicine and Hematology.

The therapeutic apheresis achieves effective withdrawal of harmful substances such as circulating immune complexes, auto antibodies, abnormal plasma components, excessive number of blood cells, toxins, lipids, cholesterol etc.

It has been applied in various social diseases of considerable importance such as autoimmune and malignant cardiovascular diseases when we must obtain fast effect in cases of emergency and when there were serious contraindications for the administration of conventional treatment or other therapy fails.

There is essential difference between PF and PE. In PF a small volume of plasma is removed, usually less than 1000 ml and it is replaced by crystalloid solutions. In a PE large volumes of plasma are withdrawn, usually equivalent to one plasma volume, approximately 40 ml/kg. Plasma or colloid plasma fractions must be administrated to avoid symptoms of hypovolemia and oncotic balance disturbance. A great number of diseases /hematological, neurological, renal, metabolic, autoimmune and rheumatic/ are treated by plasma exchange and plasmapheresis. The plasma exchange or the plasmapheresis are not a radical treatment. Different therapeutic approaches can be used to support apheresis therapy such as: chemotherapy, corticosteroids, immunoglobulins etc.

The future of apheresis belongs to high selective withdrawal of plasma components using new technologies for blood centrifugation and filtration. Only harmful substances are absorbed from the whole blood or plasma, while the normal components are subsequently transfused back to the patients in an extracorporeal circuit. The selective extraction of the plasma components permits the use of patient's own plasma for replacement, resulting in more physiologic, more effective and less costly treatment.

There are several kinds of therapeutic cytaphereses.

Leucapheresis is carried out in patients suffering from chronic or acute leukemia with heavy leucostasis syndrome.

Plateletapheresis is generally recommended in excess number of platelets in patients with thrombotic or hemorrhagic syndrome as well.

Erythrocytapheresis is indicated in patients with polycythemia vera but it's cost is very expensive.