Table 1.
ECP devices in current use in adults and children (adapted from Wong and Jacobsohn) 7
| Methodology | Automated | Weight limit |
Cell separator Extracorporeal volumes |
Cell separator technology |
|---|---|---|---|---|
| One‐step methods | ||||
| CELLEX® (Therakos®)* | Yes (double needle) | RBC prime needed if >115% ECV | Variable, dependent on Hct, blood volume processed, return bag threshold (lower than UVAR XTS) | IFC (continuous buffy coat collection with intermittent fluid return) (Latham Bowl) |
| Yes (single needle) | RBC prime needed if >115% ECV | Variable, dependent on Hct, blood volume processed, return bag threshold (higher than double‐needle method) | CFC (Latham Bowl) | |
| UVAR XTS® (Therakos®) (not available in U.S and Europe) | Yes (single needle) | >40 kg (need to satisfy ECV limits) | Variable, dependent on Hct, number of cycles, and bowl size (225 or 125 mL) | IFC (Latham Bowl) |
| Two‐step methods † | ||||
| Spectra OPTIA® (Terumo BCT) and UVA irradiator | Yes (only cell separation) | None | 253 mL (Continuous mononuclear cell collection (CMNC), version 1.3); 147 mL (AutoPBSC procedure, Version 3.8) | CFC |
| Mini‐buffy coat and UVA irradiator | No | Smaller children | None, but limited to 5–8 mL/kg whole blood draw | Standard manual buffy centrifugation technique |
| Three‐step methods ‡ | ||||
| Spectra OPTIA® (Terumo BCT) & UVAR XTS® (Therakos®) | Yes (only cell separation) | None | See above for MNC and AutoPBSC procedure | CFC |
Suitable for low bodyweight patients.
CFC, continuous flow centrifugation; ECV, extracorporeal cell volume; Hct, haematocrit; IFC, intermittent flow centrifugation; MNC, mononuclear cell; PBSC, peripheral blood stem cell; RBC, red blood cell.
Only cell separation is automated, while the UVA irradiator is operated manually. Other dedicated continuous or intermittent T‐cell separators may also be used, such as Amicus (Fenwal, MNC kit) and AS104 (Fresenius Kabi) which have extracorporeal volumes of 163 and 175 Ml, respectively.
Three‐step methods involve standard mononuclear cell collection using dedicated continuous cell separators followed by red blood cell priming of the UVAR‐XTS instrument and photoactivation treatment of the 8‐methoxypsoralen treated mononuclear cells within the UVAR‐XTS instrument after programming the instrument that the last ECP cycle has occurred.