Any type of hemapheresis is an invasive surgical procedure, temporarily modifying the circulating blood of a person. In some cases, it can be likened to an amputation, except that the amputated blood components grows back again. Obviously, such a procedure has many effects on the subject, some immediately apparent, some not.
Vascular Effects
To modify blood, one must have access to it, and this means an interplay of veins and needles. Willy nilly, there is vascular damage. In donors, this is usually minor and temporary, but in patients it can be considerable, and when a patient already has damaged peripheral veins, access may be nearly impossible. In such a case, one may have to resort to the use of various types of intravenous catheters, or even to the insertion of an arteriovenous shunt or fistula if hemapheresis must be performed. The latter expedient, of course, is not lightly undertaken, since it has permanent effects on the patient. Complications have included stroke, and gangrene requiring amputation.
Other problems of vascular access include such things as venous spasm or collapse, preventing adequate outflow of blood to the separator, and infiltration or hematoma, either of which can prevent inflow or outflow. Repeated hemapheresis procedures, like any other repeated vascular insult, can result in venous thrombosis and progressive reduction in the number of available venous sites.