{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T02:45:13Z","timestamp":1782701113378,"version":"3.54.5"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T00:00:00Z","timestamp":1782604800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T00:00:00Z","timestamp":1782604800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ther Apher Dial"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Establishing a comprehensive apheresis medicine program in a resource\u2010constrained setting presents significant structural, financial, and logistical challenges. Despite the growing clinical importance of apheresis services globally, published experience from sub\u2010Saharan Africa remains sparse. This study describes the 5\u2010year operational experience of building and sustaining an Apheresis Medicine program at Next Hematology Medicare, a private hematology center in Lagos, Nigeria, including the challenges encountered, solutions implemented, and clinical outcomes achieved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review of all apheresis procedures performed between May 2020 and December 2025 was conducted. Therapeutic apheresis procedures included automated red cell exchange transfusion (RCE), therapeutic plasma exchange (TPE) and leukocytapheresis. Donor apheresis procedures comprised single\u2010donor apheresis platelet collections for transfusion and stem cell collection (SCC) by donors. Data on patient demographics, clinical indications, procedural outcomes, and geographic distribution of platelet delivery were collected and analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 2405 apheresis procedures were performed over the 5\u2010year period. Donor apheresis platelet (AP) collection was the most frequently performed procedure (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091772; 73.7%), followed by RCE (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009617; 25.7%) as the most common therapeutic apheresis modality. TPE accounted for 12 procedures (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912; 0.5%), while leukocytapheresis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092; &lt;\u20090.1%) and SCC (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091; &lt;\u20090.1%) were performed infrequently. For AP, Sepsis\/DIC was the leading transfusion indication (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009968; 54.6%). RCE was performed predominantly for patients with sickle cell anemia (SCA), with intractable recurrent vaso\u2010occlusive crises (VOC) being the most common indication (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009382; 61.9%). RCE significantly reduced hemoglobin S (HbS%) from 93.13%\u2009\u00b1\u200912.4% to 18.74%\u2009\u00b1\u20094.2% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and improved hematocrit from 16.34%\u2009\u00b1\u20093.5% to 26.01%\u2009\u00b1\u20094.2% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). TPE was primarily indicated for neurological and transplant\u2010related conditions. Apheresis platelets were distributed nationally across all six geopolitical zones and internationally.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A fully functional Apheresis Medicine program can be successfully established and sustained in a resource\u2010constrained low\u2010 and middle\u2010income country (LMIC) setting, delivering outcomes comparable to high\u2010income country benchmarks. RCE showed significant hematological benefits for patients with SCA, and donor apheresis platelet delivery extended care across all Nigerian geopolitical zones. The operational framework described here, addressing funding, infrastructure, staffing, licensing, and blood safety, provides a possibly replicable model for Apheresis Medicine program development across sub\u2010Saharan Africa.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1744-9987.70176","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T02:04:38Z","timestamp":1782698678000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Establishing an Apheresis Medicine Program in a Resource\u2010Constrained Setting: A 5\u2010Year Experience From Lagos, Nigeria"],"prefix":"10.1002","author":[{"given":"Folasade","family":"Adelekan\u2010Popoola","sequence":"first","affiliation":[{"name":"Next Hematology Medicare  Lagos Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shakirat","family":"Gold\u2010Olufadi","sequence":"additional","affiliation":[{"name":"Brookdale University Hospital and Medical Center  Brooklyn New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olufunto Olufela","family":"Kalejaiye","sequence":"additional","affiliation":[{"name":"Division of Clinical Hematology, College of Medicine University of Lagos\/Lagos University Teaching Hospital  Lagos Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullateef","family":"Ogala","sequence":"additional","affiliation":[{"name":"Next Hematology Medicare  Lagos Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3357-6949","authenticated-orcid":false,"given":"Rasheed A.","family":"Balogun","sequence":"additional","affiliation":[{"name":"Division of Nephrology University of Virginia  Charlottesville Virginia USA"},{"name":"Department of Pathology University of Virginia  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,28]]},"reference":[{"issue":"2","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1002\/jca.22043","article-title":"Guidelines on the Use of Therapeutic Apheresis in Clinical Practice \u2013 Evidence\u2010Based Approach From the Writing Committee of the American Society for Apheresis: The Ninth Special Issue","volume":"38","author":"Connelly\u2010Smith L.","year":"2023","journal-title":"Journal of Clinical Apheresis"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.20249"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.20247"},{"key":"e_1_2_10_5_1","first-page":"1","volume-title":"Apheresis: Principles and Practice","author":"McLeod B.","year":"2010"},{"issue":"3","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1002\/jca.21705","article-title":"Guidelines on the Use of Therapeutic Apheresis in Clinical Practice \u2010 Evidence\u2010Based Approach From the Writing Committee of the American Society for Apheresis: The Eighth Special Issue","volume":"34","author":"Padmanabhan A.","year":"2019","journal-title":"Journal of Clinical Apheresis"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21470"},{"issue":"3","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1111\/j.1365-3148.2010.00992.x","article-title":"Assessment of the Clinical Transfusion Practice at a Regional Referral Hospital in Uganda","volume":"20","author":"Natukunda B.","year":"2010","journal-title":"Transfusion Medicine"},{"issue":"2","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1111\/j.1537-2995.2009.02444.x","article-title":"Relative Safety of First\u2010Time Volunteer and Replacement Donors in West Africa","volume":"50","author":"Allain J. 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