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Apheresis in Companion Animals
Steven Suter, VMD, MS, PhD, DACVIM (Oncology)

Canine Bone Marrow Transplant Unit, NC State University College of Veterinary Medicine, Raleigh, NC, USA

Apheresis, which in Greek means “a taking away,” is an blood back into the patient. Because an anticoagulant,
extracorporeal therapy that has been an important part of such as ACD‐A, is added to the blood after it leaves the
physician‐based medicine since the early 1970s. With the patient and before it enters the machine, apheresis
development of sophisticated cell separator machines patients actually experience very little loss of blood
and the commercial availability of human cytokines, cen- volume during the procedure.
trifugal apheresis is an essential component in the treat- The most popular cell collectors for physician‐based
ment of a wide variety of human diseases, including medicine are the COBE® Spectra and Spectra Optia®
cancer. Fortunately, with the availability of used, human apheresis systems manufactured by TerumoBCT ( formerly
cell separator machines to veterinarians employed at CaridianBCT) and CS‐3000 Plus and Amicus TM apheresis
both academic institutions and high‐end specialty prac- systems manufactured by Fresenius Kabi (formerly
tices, centrifugal apheresis is beginning to be recognized Fenwal, Inc). Other popular machines, due to their small
as a valuable tool in the treatment of a variety of canine size and portability, are the Haemonetics® MCS®+8150
diseases. This review will discuss how cell separators Multicomponent Collection System (red blood cells and
(also called apheresis machines) work, briefly discuss plasma only) and the MCS®+9000 Mobile Platelet
physician‐based applications of apheresis, and review the Collection System.
current state of companion animal apheresis.

Physician‐Based Applications
Cell Separator Machines of Apheresis

All cell separator machines, regardless of the manufac- The most widely used application of cell separator
turer, are designed to separate specific blood compo- machines in physician‐based medicine is the collection
nents, most often based on cell density centrifugation. of platelets (plateletpheresis) for use in cancer patients
Therefore, an integral component of all machines is a receiving chemotherapy, radiation treatments, or bone
large‐scale centrifuge that is able to continuously sepa- marrow transplants, as well as patients with aplastic
rate blood into various fractions, including white blood anemia and blood coagulation disorders. It takes
cells (WBCs), platelets, and serum using continuous approximately five whole units of blood to harvest
flow centrifugation (CFC). This means the blood can be the amount of platelets that can obtained from one
collected into the machine, centrifuged, and returned to 90‐minute plateletpheresis. Therefore, one unit of plate-
the patient simultaneously. The component of interest is lets harvested using plateletpheresis can be used to treat
typically pumped into a separate collection bag while the 2–3 patients (www.redcrossblood.org/donating‐blood/
rest of the unused blood components are returned to the types‐donations/platelet‐donation). Plateletpheresis is
patient. Therefore, patients undergoing apheresis typi- considered absolutely safe with the most common side‐
cally have a catheter placed in each leg or a dual‐lumen effect being a tingling sensation in the lips due to tran-
catheter placed in one leg that allows blood to enter into sient hypocalcemia that is treated with calcium‐containing
the machine and pump the uncollected portions of the antacid tablets.

Clinical Small Animal Internal Medicine Volume II, First Edition. Edited by David S. Bruyette.
© 2020 John Wiley & Sons, Inc. Published 2020 by John Wiley & Sons, Inc.
Companion website: www.wiley.com/go/bruyette/clinical