Diagnosis:
Apheresis: Guidelines
• The American Society for Apheresis (ASFA) issues guidelines which are based on current evidence for the use of therapeutic apheresis.
• Four categories are used to define the indications for apheresis for diseases and syndromes.
• The strength of the recommendation for the use of apheresis is described, as well as based on the quality ofthe evidence that is currently available.
• Category I indications include disorders for which apheresis is a first-line therapy either alone or in conjunction with other treatment modalities (e.g., thrombotic thrombocytopenic purpura [TTP]).
• Category II indications include disorders for which apheresis is a second-line therapy either alone or in conjunction with other treatment modalities (example: ABO-incompatible hematopoietic cell transplant).
• Category III indications include disorders for which the efficacy and role of apheresis has not been established (example: sepsis with multiorgan failure).
• Category IV indications include disorders for which apheresis is ineffective or harmful (e.g., schizophrenia).
