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Learning About Apheresis

Blood cells in a blood vessel

What is apheresis?

Apheresis (say "af-uh-REE-sus") is the process of withdrawing blood, filtering something out of the blood, and then putting the filtered blood back into the body. It has different names depending on what is being filtered from the blood. Other names include therapeutic plasma exchange (TPE), white blood cell reduction, and red blood cell exchange.

It may be used to treat certain blood disorders, cancers, and other diseases. It also may be used to remove harmful things from the blood, such as toxins or extra iron.

Extracorporeal photopheresis (ECP) is a type of apheresis. During ECP, blood is removed. Then white blood cells are removed from the blood. These cells are combined with a medicine and exposed to ultraviolet light to help the medicine work. The treated cells are then put back into the body. After the treatment, the white blood cells are less likely to cause inflammation.

How is apheresis done?

Blood is taken by inserting an intravenous (IV) needle into a vein. The blood is processed in a machine. Then the blood goes back into the body through another IV. If it's not possible to use an IV, a central venous catheter may be used instead. It's a thin, flexible tube that goes into a large vein in the neck or chest.

Your doctor may have you go to the bathroom first. After you're attached to the machine you can't leave it until the procedure is finished.

You may need only one treatment. Or you may need many treatments over weeks or months. It depends on what type of apheresis is used and what is being treated.

How long does apheresis take?

The treatment takes about 2 to 5 hours, depending on which type of apheresis you get.

What are the risks?

Some people have side effects from apheresis. These may include an allergic reaction, fatigue, nausea, dizziness, or low blood pressure. You may feel numbness, tingling, and itching. Most side effects will stop when the treatment ends. You may feel tired for a few days.

You may get calcium supplements during the procedure to help with numbness or tingling.

If you need a central venous catheter, your doctor will talk to you about the risks. There is a low risk of things such as bleeding, infection, lung puncture, and an air bubble blocking a blood vessel (air embolism).

What can you expect after apheresis?

Your care team will watch you closely for signs of any side effects.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Where can you learn more?

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