Apheresis: Understanding the Process, Types, and Medical Uses

Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026

Quick Answer

Apheresis, also known as hemapheresis, is a medical process in which blood is removed and passed through a centrifuge to separate red cells, white cells, platelets and plasma. The machine keeps the desired component and returns the rest to the patient. [1] It is used to collect specific blood products for donation and to treat diseases by removing unhealthy blood elements. [1]

What the research says

• Plasma exchange saved more lives than plasma infusion in thrombotic thrombocytopenic purpura (TTP). In a randomized trial of 102 patients, 40 of 51 patients treated with plasma exchange had responded after 6 months versus 25 of 51 with plasma infusion (P=0.002). Deaths were 11 versus 19 (P=0.036), and overall mortality was 29% (PubMed: Rock et al., N Engl J Med, 1991 [2]).

• Plasma exchange speeds recovery in Guillain-Barre syndrome, with a higher chance of relapse. A Cochrane review of 6 trials with 649 participants found that, after 4 weeks (5 trials, 623 participants), patients treated with plasma exchange were 1.64 times as likely to improve by one or more disability grades (95% CI 1.37 to 1.96) and needed artificial ventilation less often (relative risk 0.53; 95% CI 0.39 to 0.74). Relapses were more common with plasma exchange (relative risk 2.89; 95% CI 1.05 to 7.93), yet full muscle strength recovery at one year was also more likely (PubMed: Chevret et al., Cochrane Database Syst Rev, 2017 [3]).

What is apheresis and how does it work?

Apheresis represents a sophisticated advancement in hematology, enabling healthcare providers to selectively manage blood components for both therapeutic and donor purposes. By utilizing a centrifuge machine, the procedure draws blood and spins it at high speeds to separate elements based on their density. This precision allows for the removal of abnormal blood elements or the collection of healthy ones without depleting the patient's entire blood supply.

Apheresis is a procedure that enables healthcare providers to obtain or remove red blood cells, white blood cells, platelets and plasma for medical treatment. It's also known as pheresis or hemapheresis.

Common Types of Apheresis

Depending on the medical requirement, different types of apheresis are employed to target specific blood components. Each variation serves a unique therapeutic or diagnostic goal.

Apheresis Type	Primary Target	Medical Purpose
Plasmapheresis	Plasma	Treats serious conditions through plasma exchange. [1]
Leukapheresis	White Blood Cells	Removes excess white cells to ease leukemia symptoms.
Platelet Depletion	Platelets	Prevents clotting or bleeding caused by high platelet counts.
Photopheresis	Lymphocytes	Treats cells with UVA light to fight cancer or rejection.
Red Cell Exchange	Red Blood Cells	Replaces unhealthy red cells with healthy donor cells. [1]
Stem Cell Collection	Immature Stem Cells	Obtains cells for future stem cell transplants. [1]

What medical conditions is apheresis used for?

Apheresis is a versatile tool used across multiple medical specialties. It plays a pivotal role in treating blood cancers, where it can be used to preserve healthy stem cells during chemotherapy or to remove cancerous cells directly. Additionally, it is a primary treatment for various blood and neurological disorders that do not respond well to traditional medications alone.

Conditions Managed with Apheresis

The clinical applications of apheresis are extensive, spanning from oncology to neurology:

• Blood Cancers: Acute myeloid leukemia (AML), lymphoma, and multiple myeloma. [1]

• Blood Disorders: Sickle cell anemia, cryoglobulinemia, and thrombotic thrombocytopenic purpura (TTP). [1] [2]

• Neurological Disorders: Multiple sclerosis (MS), Guillain-Barre syndrome, and myasthenia gravis. [1] [3]

• Transplant Care: Managing graft-versus-host disease (GVHD) and organ transplant rejection. [1]

What can you expect during an apheresis procedure?

Preparation for apheresis typically focuses on maintaining high levels of hydration in the days leading up to the procedure. For specific collections, such as stem cells, patients may need to take medication beforehand to mobilize cells from the bone marrow into the bloodstream. [1]

Steps of the Procedure

During the session, which takes place in a comfortable clinical setting, the following steps are generally followed:

1. Access Point: Providers insert needles into veins in both arms or use a central venous catheter. [1]

2. Blood Draw: One catheter carries blood to the centrifuge machine.

3. Separation: The machine spins the blood to isolate the required components.

4. Return: The remaining blood elements are returned to the body through the second catheter. [1]

What are the benefits, risks and safety of apheresis?

The primary benefit of apheresis is its ability to provide targeted therapy, replacing only what is unhealthy or collecting only what is needed for donation. While generally safe and performed under close medical supervision, the procedure does carry some risks associated with blood volume changes and the use of anticoagulants.

Potential Risk	Cause or Symptom
Hypocalcemia	Drop in calcium levels due to anticoagulants used in the machine. [1]
Hypotension	Low blood pressure resulting from changes in blood volume.
Electrolyte Imbalance	Fluctuations in essential minerals during the separation process.
Local Complications	Minor bleeding, bruising, or rare nerve damage at the needle site.

Conclusion

Apheresis is a vital medical procedure that bridges the gap between blood donation and advanced therapeutic intervention. By allowing for the precise manipulation of blood components, it provides hope and healing for patients facing complex cancers and chronic disorders. As technology continues to refine the centrifuge process, apheresis remains a cornerstone of modern hematological care. Patients should consult their healthcare team to understand how this procedure fits into their specific treatment plan.

Frequently Asked Questions

1. What is the difference between apheresis and regular blood donation?

Regular donation collects whole blood, whereas apheresis uses a machine to collect only specific components (like platelets or plasma) and returns the rest of the blood to the donor.

2. How long does an apheresis procedure take?

The duration varies significantly depending on the type of apheresis being performed and the volume of blood components being processed. Your provider will give you a specific estimate.

3. Is apheresis painful?

The procedure involves needle sticks similar to a standard blood draw or IV insertion. Once the catheters are in place, the process itself is generally not painful.

4. Can I go back to work after the procedure?

Most people can return to their daily routines immediately. [1] However, you should follow any specific post-procedure instructions provided by your healthcare team.

5. Why is calcium sometimes given during apheresis?

Anticoagulants used to prevent blood from clotting in the machine can lower blood calcium levels, so supplemental calcium may be provided to prevent numbness or tingling.

6. What are the most common side effects?

Common side effects include fatigue, lightheadedness, or a tingling sensation around the mouth, most of which are temporary and manageable.

7. How often can someone undergo apheresis?

The frequency depends on whether it is for donation or treatment. For treatment, the schedule is determined by the underlying medical condition and the patient's response.

8. Is the equipment sterile?

Yes, all tubing and collection kits used in the apheresis machine are sterile, single-use items that are disposed of after each procedure.

9. Can apheresis treat autoimmune diseases?

Yes, plasmapheresis is often used to remove harmful antibodies from the plasma in patients with certain autoimmune and neurological conditions.

10. What should I eat before the procedure?

It is recommended to eat a regular meal and drink plenty of fluids. Avoiding high-fat foods immediately before the procedure can help ensure a clear plasma separation.

11. How do I prepare for apheresis?

There is no single preparation routine, because it depends on why you are having apheresis, so your provider gives you specific instructions and tells you how long the procedure will take [1]. Drinking plenty of fluid in the few days beforehand is a good idea [1]. If you are donating peripheral blood stem cells, you take medication for several days beforehand to move stem cells into your bloodstream [1].

12. When should I call my doctor after apheresis?

Your provider explains which symptoms to expect, so contact them if your symptoms are more severe or intense than expected [1]. In particular, report numbness, tingling or weakness, which can signal nerve damage from the needle or catheter, excessive bleeding from the needle site, or signs of infection at the site [1]. Other possible problems include low blood pressure from reduced blood volume, low blood calcium from the anticoagulant, swelling from fluid, allergic reactions to replacement plasma or red cells, and blood clots in people at higher risk [1].

Related Reading

Thrombotic Thrombocytopenic Purpura: Symptoms and Treatment

Myasthenia Gravis: Symptoms, Causes, Diagnosis and Treatment

References

1. Cleveland Clinic. Apheresis. Cleveland Clinic. Feb. 7, 2024. https://my.clevelandclinic.org/health/procedures/apheresis

2. Rock GA, Shumak KH, Buskard NA, et al. Comparison of plasma exchange with plasma infusion in the treatment of thrombotic thrombocytopenic purpura. Canadian Apheresis Study Group. N Engl J Med. 1991;325(6):393-397. PMID 2062330. https://doi.org/10.1056/NEJM199108083250604

3. Chevret S, Hughes RA, Annane D. Plasma exchange for Guillain-Barre syndrome. Cochrane Database Syst Rev. 2017;2(2):CD001798. PMID 28241090. https://doi.org/10.1002/14651858.CD001798.pub3

Medical Disclaimer

This article is for informational purposes only and does not constitute medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read here.