Abstract：
BACKGROUND: Apheresis practices in the United States (US) have not been comprehensively characterized to date. This study aimed to address this gap by evaluating apheresis therapy through a national survey.
METHODS: A multi-institutional survey was conducted between April and July 2023. The survey, comprising 54 questions, focused on institutional demographics, procedures, equipment, staffing, training, and impacts of the Coronavirus Disease 2019 (COVID-19) pandemic. Responses from 22 institutions, primarily academic medical centers, were analyzed.
RESULTS: Therapeutic plasma exchange (TPE) was the most common procedure, followed by hematopoietic progenitor cell collection (HPC-A) and red blood cell exchange (RCE). CAR-T cell collections were widespread, with some institutions supporting over 30 protocols concurrently. Most sites used the Spectra Optia Apheresis System, were managed by a transfusion medicine service, and employed internal apheresis providers. Insufficient staffing levels, exacerbated by the COVID-19 pandemic, were common and most often addressed using overtime.
CONCLUSIONS: The survey highlighted the ubiquity of TPE, expanding cellular collections and staffing challenges. The role of apheresis in supporting cellular therapy, particularly in newly developing cell and gene therapies and clinical trials, was evident. Staffing issues during the pandemic emphasized the need for innovative recruitment strategies.
CONCLUSIONS: This nationwide survey provides the most comprehensive analysis to date of apheresis practices in large US academic centers.
METHODS: A multi-institutional survey was conducted between April and July 2023. The survey, comprising 54 questions, focused on institutional demographics, procedures, equipment, staffing, training, and impacts of the Coronavirus Disease 2019 (COVID-19) pandemic. Responses from 22 institutions, primarily academic medical centers, were analyzed.
RESULTS: Therapeutic plasma exchange (TPE) was the most common procedure, followed by hematopoietic progenitor cell collection (HPC-A) and red blood cell exchange (RCE). CAR-T cell collections were widespread, with some institutions supporting over 30 protocols concurrently. Most sites used the Spectra Optia Apheresis System, were managed by a transfusion medicine service, and employed internal apheresis providers. Insufficient staffing levels, exacerbated by the COVID-19 pandemic, were common and most often addressed using overtime.
CONCLUSIONS: The survey highlighted the ubiquity of TPE, expanding cellular collections and staffing challenges. The role of apheresis in supporting cellular therapy, particularly in newly developing cell and gene therapies and clinical trials, was evident. Staffing issues during the pandemic emphasized the need for innovative recruitment strategies.
CONCLUSIONS: This nationwide survey provides the most comprehensive analysis to date of apheresis practices in large US academic centers.
摘要：
背景：迄今为止，美国（US）的单采手术实践尚未得到全面表征。这项研究旨在通过一项全国调查评估单采疗法来解决这一差距。
方法：在2023年4月至7月之间进行了多机构调查。调查,包括54个问题，专注于机构人口统计，程序,设备,人员配备，培训,以及2019年冠状病毒病（COVID-19）大流行的影响。来自22个机构的回应，主要是学术医疗中心，进行了分析。
结果：治疗性血浆置换（TPE）是最常见的方法，其次是造血祖细胞收集（HPC-A）和红细胞交换（RCE）。CAR-T细胞集合广泛存在,一些机构同时支持30多个协议。大多数网站使用光谱光学分离系统，由输血医学服务管理，并雇用内部单采药物提供者。人员配备不足，COVID-19大流行加剧了，是常见的，最常使用加班来解决。
结论：调查强调了TPE的普遍存在，扩大蜂窝收藏和人员配备挑战。单采术在支持细胞治疗中的作用，特别是在新开发的细胞和基因疗法以及临床试验中，很明显。大流行期间的人员配置问题强调了创新征聘战略的必要性。
结论：这项全国性调查提供了迄今为止在美国大型学术中心进行的最全面的分析。
方法：在2023年4月至7月之间进行了多机构调查。调查,包括54个问题，专注于机构人口统计，程序,设备,人员配备，培训,以及2019年冠状病毒病（COVID-19）大流行的影响。来自22个机构的回应，主要是学术医疗中心，进行了分析。
结果：治疗性血浆置换（TPE）是最常见的方法，其次是造血祖细胞收集（HPC-A）和红细胞交换（RCE）。CAR-T细胞集合广泛存在,一些机构同时支持30多个协议。大多数网站使用光谱光学分离系统，由输血医学服务管理，并雇用内部单采药物提供者。人员配备不足，COVID-19大流行加剧了，是常见的，最常使用加班来解决。
结论：调查强调了TPE的普遍存在，扩大蜂窝收藏和人员配备挑战。单采术在支持细胞治疗中的作用，特别是在新开发的细胞和基因疗法以及临床试验中，很明显。大流行期间的人员配置问题强调了创新征聘战略的必要性。
结论：这项全国性调查提供了迄今为止在美国大型学术中心进行的最全面的分析。
