Stem Cell Collection Procedure – Leukapheresis

Stem Cell Collection Procedure – Leukapheresis

Leukapheresis is the removal of white blood cells (leukocytes) from the peripheral blood with the use of an aphresis machine that makes collection of the monocytes fraction only.

Before each procedure, the staff opens and applies a new and sterile disposable kit for each donor to a machine. The kit is made up of sterile tubing. Your blood comes into contact only with the interior of this tubing. Under no circumstances does your blood come into contact with the machine. There is no potential for cross contamination with blood from a previous donor.

The process requires access to veins in both arms.

If veins on both arms are not big enough for the collection process or found to be too small or not suited for the collection process, a femoral (a vein located in the upper thigh and pelvic region of the body) or jugular (a vein located on both sides of the neck connecting the large vein just beneath the collar bone) vein access procedure called femoral vein catheterization will be scheduled with a vascular surgeon (a surgical specialist who cares for patients with diseases that affect the arteries, veins and lymphatic systems exclusive of the heart and within the brain circulations.) to be done an hour before the scheduled leukapheresis procedure.

Local anesthesia is applied.

The procedure which usually takes about 30 minutes is done by a Vascular Surgeon, sometimes with the help of a portable ultrasound machine.

Scheduling

Once you avail of the stem cell treatment, the IPMM nurse will do an assessment and list all the medications you are taking or have taken within the last seven (7) days.

If you are taking blood thinners or anti-coagulants, the schedule of your procedure may be pushed to a later date.

After the assessment of the Institute of Personalized Molecular Medicine (IPMM) nurse, you will be given a schedule for the collection of stem cells (Leukapheresis) at the IPMM-Regenerative Medicine Clinic.

How will you prepare for leukapheresis?

• There are no diet restrictions

-          Eat and drink as usual.

-          Take usual medications on the collection day.

• Do not take anticoagulants. Aspirin and anticoagulants increase the risk of bleeding and bruising.

If you are taking these, you should contact the doctor managing these medications to see if these can be safely stopped prior to the collection.

• Do not take herbal supplements

Herbal substance such as Gingko Biloba should be stopped two weeks prior to leukapheresis.

• Identification of known allergies

You should advise the nurse of allergies to latex (natural rubber latex) and lidocaine (anesthetis drug) as well as any history of taking anticoagulants, prior to appointment.

• Wear comfortable clothing.
• You may bring with you materials that might keep you entertained throughout the whole procedure but which doesn’t require movement of the puncture site.

What happens one (1) day before the stem cell collection?

1. You will be asked to come to the IPMM clinic.
2. The IPMM nurse will do an initial assessment of your condition and administer medications that will help increase your white blood cells.
3. A medical technologist from the Blood Bank will also be there to assess your vein if it is suitable for leukapheresis or if there is a need for femoral vein catheterization.
4. You will be asked to sign the informed consent form.

Signing the informed consent form means you understand the procedure, including the risks and complications of having and not having it done. This also means that you agree to have you stem cells collected.

What happens on the day of the stem cell collection?

1. On the day of your leukapheresis, you will be asked to come at least fifteen (15) minutes before the procedure.

You may use the bathroom before you proceed to the procedure room or you may request for a bedpan/urinal for use while the procedure is on-going.

1. When you are taken into the procedure room, you will be placed on a semi-fowler’s position (head of bed elevated to 30 degrees) or to any position of comfort.
2. You will be hooked to a machine that collects your stem cells.

• Blood is extracted from one arm into a machine that sorts out the various blood components according to their density and weight.
• The other types of blood cells as well as the liquid components of blood are returned back to the patient.
• About 90 to 100 ml of stem cells are collected during the procedure.

The procedure which usually takes about four to five (4-5) hours is done by a Medical Technologist and supervised by an IPMM Hematologist.

What happens after the procedure?

Once the stem call collection is complete, you will be asked to lie on your back for 20 to 30 minutes.

The IPMM nurse will your vital signs and bandage for bleeding.

The IPMM Hematologist will write the home instructions. These include:

1. Do not remove the dressing bandage for at least 24 hours.
2. Taking a bath is possible but make sure that the puncture site will not get wet.
3. You may take Paracetamol or NSAIDS (Non-steroidal Anti-inflammatory Drug) for pain.
4. In case of redness, swelling or hematoma around the punctured site, please call the Institute of Personalized Molecular Medicine.

How can The Medical City help you?

At The Medical City, we have a complete roster of competent doctors who can assess and treat patients needing leukapheresis.

If you have any questions, please feel free to contact us at the Institute of Personalized Molecular Medicine (Regenerative Medicine Clinic) at (632) 988-1000 / (632) 988-7000 local 6307 / 6551.