plasmapheresis

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Enkidu

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What sort of clinical decision-making is required of pathologists regarding plasmapheresis? Is it mostly just a supervisory type thing?

Is plasmapheresis considered part of blood-banking? I've read something vague about a group of procedures called "cellular therapy", in which some blood components are fractioned out and treated in some way before being re-added. Is this something that will become significant, or is it mostly a pipe-dream?
 
Also, what is the role of pathology in kidney dialysis? Is this essentially the same as plasmapheresis?
 
Both involve removing patient's blood, fiddling with it and returning it to the body. Similarities mostly stop there. Dialysis mostly involves osmosis as its underlying mechanism of action; pheresis mostly involves centrifugation. (My one line summary of two complex subspecialty areas of endeavor.)

Pathologists are quite involved in pheresis including fretting about indications, assessing patients before the procedure, performing it (obviously with help of technical staff and nurses) and following up. Physician level expertise is needed, although, like for signing out a tubular adenoma, sometimes you might wonder. You are correct, this is considered part of blood banking and a BB fellowship would be the way to gain subspecialty expertise.

Cellular therapies--you have the right idea--one current "vogue" application is tumor vaccines in which the patient's tumor is cooked with some naive lymphocytes or dendritic cells, etc., harvested from the patient. Depending on who you talk to, you will probably be able to elicit very positive or negative opinions as to the outlook for these technologies. Stem cell transplant is probably the most mainstream application of this concept. Other applications are pretty much used in research contexts only at this point.

To my knowledge dialysis is entirely owned by nephrology; never heard of path being involved.
 
I think there are places where the apheresis service is run by nephrology rather than pathology.
 
Many programs have shifted plasmapheresis to nephrology and away from Transfusion Medicine. My program will be doing so this July. While it's removing one of the last vestiges of patient contact from the field, it was a logical decision. And I can guarantee the CP residents will be grateful to see it go.
 
icpshootyz said:
Many programs have shifted plasmapheresis to nephrology and away from Transfusion Medicine. My program will be doing so this July. While it's removing one of the last vestiges of patient contact from the field, it was a logical decision. And I can guarantee the CP residents will be grateful to see it go.
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Why is this logical? It seems like transfusion medicine is the more logical than nephrology for blood-related treatments.
 
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