Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
J Clin Apher. 2024 Aug;39(4):e22138. doi: 10.1002/jca.22138.
Apheresis 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.
A 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.
Therapeutic 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.
The 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.
This nationwide survey provides the most comprehensive analysis to date of apheresis practices in large US academic centers.
截至目前，美国（美国）的血浆分离术实践尚未得到全面描述。本研究旨在通过全国性调查来填补这一空白。
2023 年 4 月至 7 月期间进行了一项多机构调查。该调查包括 54 个问题，重点关注机构人口统计学、程序、设备、人员配备、培训以及 2019 年冠状病毒病（COVID-19）大流行的影响。对来自 22 个机构的答复进行了分析，这些机构主要是学术医疗中心。
治疗性血浆置换（TPE）是最常见的程序，其次是造血祖细胞采集（HPC-A）和红细胞交换（RCE）。CAR-T 细胞采集广泛存在，一些机构同时支持超过 30 种方案。大多数站点使用 Spectra Optia 血浆分离系统，由输血医学服务管理，并雇用内部血浆分离术提供者。人员配备水平不足，COVID-19 大流行加剧了这一问题，通常通过加班来解决。
该调查突出了 TPE 的普遍性、不断扩大的细胞采集以及人员配备挑战。血浆分离术在支持细胞疗法方面的作用显而易见，特别是在新兴的细胞和基因疗法以及临床试验中。大流行期间的人员配备问题强调了需要采用创新的招聘策略。
这项全国性调查提供了迄今为止对美国大型学术中心血浆分离术实践的最全面分析。
