Apheresis Program

The Renal Center provides a broad range of therapeutic apheresis services, on both an inpatient and outpatient basis, completing approximately 600 procedures annually. Foundation for the Accreditation of Cellular Therapy (FACT) accredited since 2005, this certification means our program has met the highest standards of patient care, achieving excellence in cellular therapy.

Apheresis is where blood is drawn from the patient’s body, processed and either returned to the body’s bloodstream or replaced with donor blood. Processing may include removal of the patient’s plasma, blood platelet, or while blood cells.


Procedures include

  • Leuko-depletion (Leukocytapheresis)
  • Peripheral stem cell harvesting or Collection of hematopoietic stem cells (HPC)
  • Red cell exchange (RCE) (Erythrocytapheresis)
  • Therapeutic plasma exchange (TPE) same as Plasmapheresis
  • T-cell collection

Multidisciplinary approach

The scope of our program allows for multidisciplinary expertise. This includes nurses who are cross-trained to work with high acuity patients in both dialysis and pheresis procedures, and may be set up in tandem with other services such as ECMO (extracorporeal membrane oxygenation), CRRT (continual renal replacement therapy) and cardiac bypass. Our close collaboration with pediatric surgeons and interventional radiologists help in securing vascular access which is a critical component of any extracorporeal therapy. Our model has always been an interdisciplinary approach with a team of nephrologists, transfusion medicine specialists, advanced care providers and nursing experts managing the clinical operations of apheresis therapy. We have formulated clinical guidelines with other partners who utilize our services such as hematology/oncology, neurology, bone marrow and sold organ transplant and critical care sections to help streamline workflow.


Patient care

Our patients encompass the entire pediatric age range, starting from neonates on ECMO to young adults. Our workflow starts with a pheresis consult so that we can work with the patient and the family, and the primary service to provide a detailed outline of apheresis procedure so that families fully understand the process completely before we start. The Child Life team in our outpatient unit is an active partner, helping to calm patients and support families during the actual procedure.  


Collaboration

We have served as a pediatric resource for other programs and have partnered with programs such as Children’s Hospital of San Antonio and Scott and White Children’s Hospital in sharing our pediatric expertise and experience in therapeutic apheresis.


Photopheresis

Photopheresis—or extracorporeal photopheresis (ECP)—is a type of apheresis which refers to various blood-filtering methods used to treat certain diseases and conditions. These treatments involve removing blood, passing it through specialized equipment that separates it into components, then reintroducing those desired components back into the bloodstream.

Immunotherapy has shown much success in the treatment of pediatric patients with graft-versus-host disease (GvHD), an immune system complication after bone marrow or stem cell transplantation caused when donor stem cells mistakenly attack the body’s healthy cells. The procedure is also used to treat organ rejection after transplant as well as cutaneous T-cell lymphoma (CTCL), a rare type of cancer in which white blood cells develop abnormalities primarily affecting the skin.


Why Choose Texas Children’s?

Consistently ranked as the best pediatric hospital in Texas and among the top in the nation, Texas Children’s Hospital is committed to providing exceptional, compassionate care in an environment tailored for children and their families. From assessment and diagnosis through treatment and follow-up, we offer the latest diagnostic tools and most advanced therapies available in treating conditions that call for the use of photopheresis.

Our board-certified pediatric medicine specialists and other highly trained staff offer a multidisciplinary approach to ensure the best possible treatments and most successful outcomes. Additionally, Texas Children’s is one of only two photopheresis programs of its kind in the Houston area, and the only one dedicated to the unique needs of children. In many cases, multiple specialties—including nephrology, hematology, oncology, immunology, cardiology, pulmonology and other disciplines—collaborate to develop a comprehensive and personalized treatment plan for each individual patient.


What to Expect

During photopheresis, a small amount of blood is drawn intravenously from the patient (or donor), white blood cells are separated and combined with a photoactive drug, exposed to ultraviolet (UVA) light, then returned to the bloodstream. With this type of targeted immunotherapy, the treated white blood cells are used to stimulate the patient’s own immune system to fight the disease and help repair cellular damage. Depending on the condition being treated, photopheresis may be used alone or in combination with other treatments.

Although it varies from patient to patient, photopheresis is a series of repeated outpatient treatments over several months and typically involves:

  • Treatment administered intravenously via dialysis catheter
  • 30 sessions (2-3½ hours each), 3 days per week over 10 weeks
  • Expert team of pediatric medicine specialists and other highly trained staff

While there may be slight discomfort at the needle site, and occasional light-headedness or nausea during photopheresis, most patients tolerate the treatment well. During the course of care, team members are with the patient at all times to provide comfort and ensure the procedure goes smoothly. If your child requires photopheresis treatment, contact Texas Children’s or request a referral from a specialist or primary care physician.


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