A multi‐institutional survey of apheresis services among institutions in the United States

Author:

Yurtsever Nalan1,Jacobs Jeremy W.2ORCID,Booth Garrett S.3,Schwartz Joseph4,Park Yara A.5,Woo Jennifer S.6,Lauro Deisen7,Torres Sarina7,Ward Dawn C.8,Stephens Laura D.9ORCID,Allen Elizabeth S.9,Tormey Christopher A.1ORCID,Adkins Brian D.10ORCID

Affiliation:

1. Department of Laboratory Medicine Yale School of Medicine New Haven Connecticut USA

2. Department of Laboratory Medicine and Pathology Mayo Clinic Rochester Minnesota USA

3. Department of Pathology, Microbiology, & Immunology Vanderbilt University Medical Center Nashville Tennessee USA

4. Department of Pathology Moffitt Cancer Center Tampa Florida USA

5. Department of Pathology and Laboratory Medicine UNC School of Medicine Chapel Hill North Carolina USA

6. Department of Pathology City of Hope National Medical Center Irvine California USA

7. Division of Transfusion Medicine City of Hope National Medical Center Duarte California USA

8. Wing‐Kwai and Alice Lee‐Tsing Chung Transfusion Service, Department of Pathology and Laboratory Medicine David Geffen School of Medicine at UCLA Los Angeles California USA

9. Department of Pathology University of California, San Diego La Jolla California USA

10. Department of Pathology University of Texas Southwestern Medical Center Dallas Texas USA

Abstract

AbstractIntroductionApheresis practices in the United States (US) have not been comprehensively characterized to date. This study aimed to address this gap by evaluating apheresis therapy through a national survey.MethodsA multi‐institutional survey was conducted between April and July 2023. The survey, comprising 54 questions, focused on institutional demographics, procedures, equipment, staffing, training, and impacts of the Coronavirus Disease 2019 (COVID‐19) pandemic. Responses from 22 institutions, primarily academic medical centers, were analyzed.ResultsTherapeutic plasma exchange (TPE) was the most common procedure, followed by hematopoietic progenitor cell collection (HPC‐A) and red blood cell exchange (RCE). CAR‐T cell collections were widespread, with some institutions supporting over 30 protocols concurrently. Most sites used the Spectra Optia Apheresis System, were managed by a transfusion medicine service, and employed internal apheresis providers. Insufficient staffing levels, exacerbated by the COVID‐19 pandemic, were common and most often addressed using overtime.DiscussionThe survey highlighted the ubiquity of TPE, expanding cellular collections and staffing challenges. The role of apheresis in supporting cellular therapy, particularly in newly developing cell and gene therapies and clinical trials, was evident. Staffing issues during the pandemic emphasized the need for innovative recruitment strategies.ConclusionThis nationwide survey provides the most comprehensive analysis to date of apheresis practices in large US academic centers.

Publisher

Wiley

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