Small Team, Powerful Impact in Apheresis Care

Therapeutic apheresis requires a specialized machine, and an even more specialized nursing staff. This procedure removes harmful components from a child’s blood, such as antibodies, toxins or excess cells, in addition to collecting stem cells or CART-T cells, to help treat conditions like sickle cell disease, transplant rejection and cancer, among many others.

As a part of the Pathology and Laboratory Services team, nurses like Samantha Haimbaugh, RN, collaborate across disciplines and departments to treat complex conditions. To hold these positions, team members must undergo extensive training that can take up to a year. The team is one of very few in pediatric hospitals that can support both inpatient and outpatient care through their rare blend of advanced technical expertise and deep clinical experience.

“We have six nurses, so it’s a small but mighty team,” Haimbaugh says. “We float throughout the hospital to every unit from the ICUs to the OR.”

Many of the team’s nurses come from pediatric critical care backgrounds, allowing them to assess complex patients while also managing highly specialized procedures. This versatility allows them to provide consistent, specialized care wherever patients need it.

Long hours behind lifesaving care

Unlike more routine blood-based therapies like dialysis, which primarily rely on filtration, therapeutic apheresis treatments are highly individualized and may require families to travel long distances. Apheresis removes harmful components from a child’s blood or plasma using centrifugation, a process that separates blood based on cellular weight rather than passing it through a filter. During this process, heavier components like red blood cells are directed toward the outer edges of the channel, and lighter components, like plasma, remain closer to the inner portion and can be selectively removed. The remaining blood components are then returned to the patient. Treatments can last several hours and require continuous monitoring and fast decision-making by the care team.

“These nurses are so amazing,” says Kyle Annen, DO, Medical Director of Transfusion and Patient Blood Management. “They are with patients for sometimes eight hours, right there at the machine. There are days that are mentally and emotionally draining, but it’s so rewarding.”

Part of sickle cell gene therapy

For kids with sickle cell disease, therapeutic apheresis often plays different roles at different points of care. Prior to gene therapy, many patients undergo routine red blood cell exchanges, often monthly, to reduce complications. However, stem cell collection for gene therapy is a specific and time-limited process, focused on obtaining enough cells for personalized treatment. These cellular collections may need to be repeated and can require multiple visits over a shorter period of time. After successful gene therapy, children no longer require routine red blood cell exchanges, marking a significant transition in both their medical care and their relationship with the apheresis team.

“Collaborating with other pediatric facilities and knowing based on other patient experiences they have been cured, there’s light at the end of the tunnel and encouragement for patients after all the treatment,” Haimbaugh says.

As therapeutic apheresis continues to play an important role in managing complex pediatric conditions, it requires specialized teams who can respond to each patient’s changing needs. Through clinical expertise, collaboration and continuity of care, nurses play a vital role in helping children with complex conditions move forward.