Transfusion Thresholds in Apheresis—Evidence or Art? Current Practice and Interactive Discussion

Program Chair(s)

• 

  Jensyn Cone Sullivan, MD

  Director, Blood Bank
  Department of Pathology, Michigan Medicine at the University of Michigan
  Ann Arbor, Michigan, United States

  Disclosure(s): Hansa Biopharma: Consultant/Advisory Board (Terminated, December 24, 2023), Grant/Research Support (Terminated, December 24, 2023)

Speaker(s)

• 

  Jensyn Cone Sullivan, MD

  Director, Blood Bank
  Department of Pathology, Michigan Medicine at the University of Michigan
  Ann Arbor, Michigan, United States

  Disclosure(s): Hansa Biopharma: Consultant/Advisory Board (Terminated, December 24, 2023), Grant/Research Support (Terminated, December 24, 2023)
• 

  Kyle Annen, DO, CABP, QIA (ASCP) (she/her/hers)

  Medical Director of Apheresis and Cellular Therapy
  Department of Pathology, University of Colorado-Anschutz School of Medicine
  Denver, Colorado, United States

  Disclosure(s): QuidelOrtho: Honoraria (Terminated, December 31, 2023)

  PDF

Program Chair(s)

• 

  Kyle Annen, DO, CABP, QIA (ASCP) (she/her/hers)

  Medical Director of Apheresis and Cellular Therapy
  Department of Pathology, University of Colorado-Anschutz School of Medicine
  Denver, Colorado, United States

  Disclosure(s): QuidelOrtho: Honoraria (Terminated, December 31, 2023)

  PDF

Session Desription: The Association for the Advancement of Blood and Biotherapies’ (AABB) Clinical Practice Guidelines for Red Blood Cell (pRBC) and platelet transfusion thresholds do not specifically address many clinical situations, including therapeutic apheresis. Thus, apheresis clinicians must extrapolate from current evidence and guidelines to guide peri-procedure transfusion support. Understanding current transfusion threshold practice among these providers would be an invaluable tool to focus research and support therapeutic apheresis-specific transfusion threshold guideline development.

In this session, representatives of the AABB’s Therapeutic Apheresis Subsection (TAS) will briefly outline evidence-based support for specific transfusion thresholds in therapeutic apheresis in adult and pediatric patients. A survey gathering information about 1) current transfusion thresholds and 2) methods and timing of blood product administration in therapeutic apheresis was distributed by the TAS to the AABB’s Therapeutic Apheresis and Transfusion Practices email distribution list. Results will be shared including the preferred pRBC and platelet transfusion thresholds for therapeutic plasma exchange in varying clinical scenarios, framed within careful consideration of therapeutic apheresis’ invasive nature and the frequent utilization of machine anticoagulation. Additionally, the session will include discussion of preferred methods for pRBC and platelet administration (i.e. pre-procedure, as prime, concurrent with, or post-procedure) in the setting of urgent apheresis. Areas of divergence in clinical practice will be highlighted.

A majority of the session will consist of real-time audience polling and interactive discussion of in-person and remote viewer results along with focused discussion of next steps. Data from the session will be collected, with the goal of a publication outlining the current spectrum of practice. Session participants providing polling responses will receive contributor acknowledgement in any resultant publications, if desired.