Children's Hospital Colorado
Center for cancer and blood disorders
Best Children's Hospital by US News Cancer 2020-1 Badge
Center for cancer and blood disorders

Contact us


Refer a patient

What is Therapeutic Apheresis?

Restoring healthy blood with therapeutic apheresis

A young girl playing with a toy

Apheresis means “to remove.” The purpose of therapeutic apheresis is to take away a component of the blood that contributes to an illness.

During apheresis, blood is safely removed from the body and sent to sterile equipment, where it is separated into various components, such as red cells, white cells and plasma.

Healthy parts of the blood are then returned to the patient.

Why choose Children’s Hospital Colorado for therapeutic apheresis?

Children's Colorado has been offering therapeutic apheresis procedures for more than 25 years, and we are uniquely equipped to offer these services to the community. While other facilities may provide apheresis capabilities, we are the only program of its kind in the Denver area dedicated to kids and the needs of pediatric patients.

Around the country, these services are often managed by doctors who don’t specialize in apheresis – but at Children’s Colorado, we have experts with a dedicated focus on all therapeutic apheresis services.

Conditions we treat

Therapeutic apheresis can help treat conditions such as:

  • Cancer, specifically in the collection of stem cells prior to bone marrow transplant
  • Blood disorders such as sickle cell disease  
  • Kidney disease
  • Transplant rejection or graft versus host disease
  • Autoimmune diseases, such as lupus

Types of therapeutic apheresis

Listed below are some of our more common procedures that can be done on an inpatient or outpatient basis:

Red blood cell exchange

  • This process is used in high-risk sickle cell patients to remove sickled red blood cells. It is typically done on a monthly basis to prevent further complications of sickle cell disease, but it may also be done in an emergency for patients in crisis.
  • Red blood cell exchange can also be used in patients with erythropoietic protoporphyria (EPP), a rare metabolic disorder.
  • Exchanges can be useful in the treatment of overwhelming malaria, although we have not been requested to do this to date.

Therapeutic plasma exchange

  • Plasma exchanges can be done for patients experiencing solid organ rejection post-transplant. Our experience has been primarily in heart rejection after a heart transplant.
  • Plasma exchanges may be done before, during and after heart transplant surgery for patients who have high antibody levels.
  • Certain kidney diseases benefit from plasma exchanges.
  • Patients diagnosed with the blood diseases thrombotic thrombocytopenic purpura (TTP) or hemolytic uremic syndrome (HUS) frequently undergo a series of therapeutic plasma exchanges.


  • We use this therapeutic apheresis treatment predominately for graft-versus-host disease affecting the skin after a transplant.
  • This procedure can be used to treat solid organ rejection patients, the majority being in heart rejection.
  • Photopheresis was initially developed for the treatment of skin problems associated with cutaneous T-cell lymphoma.

Peripheral blood stem cell collection

  • This procedure is used to collect stem cells from the blood stream to be used in a bone marrow transplant. The stem cells are then transplanted to the child after high-dose chemotherapy.

White cell depletion

  • Patients newly diagnosed with leukemia, and those who have abnormally high white blood cell counts, may undergo this procedure before safely receiving chemotherapy to remove excess white cells.

Therapeutic phlebotomy

This procedure is used primarily to treat patients who are experiencing symptoms related to polycythemia or iron overload. Blood is removed from the patient and lab tests are monitored regularly for response to treatment.

For more information

If you have questions or want more information about therapeutic apheresis, please call 720-777-3321.