About the Apheresis Program

The Children’s Hospital of Philadelphia’s Apheresis Program provides a full range of apheresis treatments for children with sickle cell disease, kidney disorders, neurologic conditions, cancer, graft-versus-host disease and other disorders.

During apheresis procedures, blood is drawn from the body, processed, and either returned to the bloodstream or replaced with donor blood or plasma.  Apheresis can be helpful for children with a variety of debilitating and life threatening conditions to recover more quickly and live more normal lives.

Our team has nearly 30 years of experience in adapting apheresis machines and protocols, originally designed and FDA-approved for adults, to be used in the treatment of children of all ages, from infants to young adults.  In addition to this technical expertise, our doctors, nurses and child life staff know just how to comfort and distract young patients who need apheresis, to help them  through placement of IV’s (needle sticks)  and to remain still during the 2- to 3-hour procedures.

Each year, we perform more than 1,800 therapeutic apheresis procedures in our state-of-the-art Apheresis Unit, making us one of the largest and most experienced pediatric apheresis programs in the nation. Many centers that perform apheresis in adults do not have the experience or capability to perform these specialized procedures in children.

CHOP’s Apheresis Program began in 1986 with one physician, one nurse and a single apheresis machine to treat children with sickle cell disease. Today, the program has more than 20 staff members, uses eight cutting-edge apheresis machines, and treats hundreds of patients each year.

Patients and services

Patients are referred to the Apheresis Program by their treating physician. In many cases, these children are already followed by CHOP’s specialists in the Sickle Cell Center, nephrology, neurology or another specialty division. Other children may be referred to CHOP for treatment specifically because of the pediatric apheresis services we offer.

  • Erythrocytapheresis is a red blood cell exchange procedure that helps patients with sickle cell disease avoid serious complications from the disorder including an overload of iron, which can be toxic to the heart, liver, pancreas and other organs. About half of the patients of the Apheresis Program are being treated for sickle cell disease.
  • Plasmapheresis is a procedure that separates the liquid part of the blood (plasma) from the cells and replaces it with healthy fluid.  It is an established treatment for a variety of autoimmune disorders involving the kidney and nervous system, disorder of lipids and cholesterol, and also complications following organ transplantation.
  • Photopheresis is a promising new treatment for children with graft-versus-host disease after a bone marrow transplant, where blood is drawn, treated with light therapy and then re-infused. In the past year, we have performed more than 100 of these procedures – many on patients who failed to respond to other treatments elsewhere.
  • Collection of hematopoietic stem cells (HPC) is part of established treatment protocols for cancers such as neuroblastoma, brain tumors, and lymphoma. HPC cells are rare cells from which the entire bone marrow and all blood cells can regrow. Stem cells are collected by apheresis and stored by the Stem Cell Lab until after a patient’s cancer treatment, then they are reinfused into the patient.
  • T-cell collection is the first step in a national clinical trial of chimeric T-cell therapy to treat a common type of childhood acute lymphoblastic leukemia, if it has not responded to other treatments. T-cell therapy has provided complete remission for some patients.
  • Leukocytapheresis, also known as white blood cell removal, is usually performed as an emergency in children who have just been diagnosed with leukemia, for whom removing leukemia cells quickly may be life-saving.
  • Therapeutic phlebotomy removes whole blood to reduce the number of red blood cells or excessive iron in a patient's body.

Most procedures are performed on an outpatient basis, during normal business hours Monday through Friday. However, we have a team of apheresis physician and nurses on call at any time for patients with urgent needs, and can provide apheresis treatment in any location in the Hospital.

Your child’s first appointment with the Apheresis Program will include an evaluation by a physician-nurse team in the Apheresis Unit, who will already know about your child and his condition. How often your child needs apheresis will depend on his condition and the recommendations from our apheresis team and your child’s treating physician.

Next Steps