Therapeutic apheresis is used to treat many diseases. The theoretical basis for the therapeutic apheresis is to reduce the patient's load of pathologic substances to levels that will allow improvement. Cells, plasma, or plasma constituents may be removed from the circulation and replaced by normal plasma, crystalloid, colloids such as starch, or albumin. Due to the infrequency of these apheresis procedures the VA Bronx and VA New Jersey Transfusion Medicine service personnel are limited in maintaining certification and expertise to perform them. The need to have a therapeutic apheresis service available upon the order and immediate direction of the medical center's staff physicians when such physicians determine those services are clinically indicated shall the patient be referred for contract service. A contract is needed to make therapeutic apheresis services available at the VA Bronx and VA New Jersey, when other options and treatments have failed or not clinically indicated. The Contractor shall provide the following therapeutic apheresis services when clinical indicated: Therapeutic Plasma Exchange (Plasmapheresis) Therapeutic Cytapheresis: White cell reduction (Leukapheresis) Platelet reduction (Plateletcytaphersis) Red cell exchange/reduction (Erythrocytapheresis) Immunoadsorption - Prosorda Column Therapy

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