A look at: Apheresis

Apheresis staff include (l-r): Winsome Smith, RN; Judy Silvia Snipes, RN; Peggy Persaud, ambulatory surgery associate; Althea Sewell, clinical apheresis associate; Sara White, RN; Anna Milani, RN; and Lindsey Roome, RN.

The Apheresis unit on NP 8 looks deceptively calm, with patients relaxing in reclining chairs or beds, connected to the complex equipment that separates out the components of their blood.

But the nurses who run this specialized unit are always on alert, frequently checking on patients, their medication and the equipment. The nurses are particularly watchful for symptoms of hypocalcemia, which can occur when the anticoagulant medications patients receive during apheresis cause their calcium levels to drop. Hypocalcemia can become life-threatening in just a few minutes, so nurses need to be ready to react quickly if they see symptoms.

“This is an exciting place to work,” said Winsome Smith, RN. “We’re highly specialized, we provide excellent care to our patients and we have a lot of autonomy.”

The term “apheresis” comes from an ancient Greek word meaning “to take away.” The procedure involves removing blood from the body and separating out one or more of its components: plasma, platelets or red or white blood cells. After the desired component is separated, the remaining blood is infused back into the patient.

There are different types of apheresis procedures, depending on which blood component is being removed and transfused. Apheresis is a key component in treatments for a wide variety of conditions in adults and children, including different cancers and autoimmune, red blood cell, neurologic and other disorders. Apheresis can also be used to help prevent transplantation recipients from rejecting donor organs.

Smilow Cancer Hospital’s Apheresis unit has recently become even busier with the introduction of Chimeric Antigen Receptor (CAR) T-cell therapy, a groundbreaking immunotherapy that can treat certain cancers. Apheresis removes patients’ white blood cells, which are reprogrammed in a lab to fight cancer, then infused back into the patient.

With the introduction of CAR T-cell therapy and a growing number of other indications for apheresis, the unit is looking for more nurses – particularly those with medicine-surgery and IV experience, said Kathleen Moseman, RN, patient service manager. Nurses are trained in the many different procedures during a six-month orientation.

Anna Milani, RN, came to the unit in 2002, with experience that included post-anesthesia care, transplantation, oncology and intensive care.

“I was attracted by the diversity of what you can do here,” she said. “You have to know a little bit about many different clinical areas because we treat all kinds of patients. Every day is something different.”