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Extracorporeal Photopheresis (ECP)
Extracorporeal photopheresis (ECP) is a painless procedure that alters your child’s immune system to fight graft-versus-host disease. During the procedure, your child’s blood is drawn into our machine through an intravenous (IV) line. In the machine, white blood cells are separated from other blood cells. The machine mixes your child’s white blood cells with a medication that causes the cells to be sensitive to ultraviolet light. The machine then treats your child’s white blood cells with light. Those cells are then returned to your child with the rest of your child’s blood cells through an IV line. The treated blood cells then stimulate your child’s immune system to fight graft-versus-host disease.
Peripheral Blood Stem Cell (PBSC)/Cellular Collections
Autologous and allogeneic stem cell collections are performed using apheresis. Your child may receive medications to stimulate their bone marrow to release stem cells into circulation. The apheresis machine then separates and collects those stem cells from circulation. This procedure may take several hours and require a specialized IV (central line) or intensive care. Those cells may then be stored for later bone marrow transplantation. Learn more about the process of a stem cell transplant.
We collaborate with our bone marrow transplant, interventional radiology and intensive care teams to ensure that your child receives the highest level of care that they need for this procedure to run smoothly. Unstimulated collections are also performed. The cells may then be modified in the laboratory and reinfused at a later time to target an attack on your child’s disease. Several clinical trials using these techniques are open at Children’s National, please talk with your child's physician about participation in clinical trials.
Red Blood Cell Exchange
We provide automated red blood cell exchanges for both acute and chronic complications of sickle cell disease. During a red blood cell exchange, blood flows from your child into the machine, which separates the red blood cells from the rest of the blood. The rest of the blood is returned to your child, with red blood cells from healthy donors while your child’s own blood cells are removed. This is a method of transfusion that limits the amount of iron patients receive and decreases the proportion of sickle cells in circulation.
Therapeutic Plasma Exchange (TPE)
Therapeutic plasma exchange is used to remove substances in the plasma that may contribute to disease, such as antibodies or cytokines. It may also be used to replace substances found in healthy plasma. Much like red cell exchange, blood is drawn from your child into the machine. The machine separates your child’s plasma from the rest of the blood. The plasma (which contains the disease-causing substance) is diverted into a waste bag, while plasma from healthy donors or other replacement fluid is mixed with your child’s red blood cells, white blood cells and platelets and returned to your child. This treatment is used to treat conditions like thrombotic thrombocytopenic purpura, antibody mediated solid organ rejection or autoimmune encephalitis.