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December 2025

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Shining a light to help more patients

As 2025 winds down, we wish you a bright season and an even brighter year ahead. In this issue of Access Point, we’re shedding a little light of our own on a helpful feature of the Spectra Optia^™ Apheresis System — custom prime. It can help reduce potential side effects and complications for patients with low total blood volume (TBV).

As always, you’ll also find resources, upcoming events, and more to help you make the most of Spectra Optia and give your patients the best care. If there is a particular topic you’d like to learn about, let us know.

Spectra Optia features

Custom prime: Giving an assist for low-TBV apheresis

When you perform a procedure using Spectra Optia on a patient with low total blood volume (TBD), there are special considerations. In this article, we’ll look at one such consideration: custom prime. Learn more about what it is, when it may be needed, and how to perform it.

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Your questions, answered

Dear Access Point,

We recently cared for a patient with low total blood volume who required a red blood cell exchange. The ordering physician requested that a custom prime be completed using 5% albumin instead of a unit of red blood cells. Could you explain how albumin works in this context?

— Angela from Colbert, GA

Dear Angela,

You may already know that a custom prime is often recommended when a patient may not tolerate the extracorporeal volume (ECV) of the tubing set — for instance, in cases of low TBV, as with your patient, or due to other clinical considerations. Using 5% albumin as the custom prime fluid is an alternative to donor red blood cells (RBCs). With albumin, you don’t need an additional bag of donor RBCs on top of what will be used for replacement fluid.

During the custom prime, albumin will be circulated through the tubing set and mixed with the first unit of replacement RBCs. This helps ensure that the hematocrit (Hct) in the return line matches the patient’s baseline Hct at the end of the prime.

To learn more about custom prime, see this month’s feature article.

Source: Terumo Blood and Cell Technologies. Red Blood Cell Exchange (V12 RBCX) Rx Only Procedure Training (including single-needle option). Part no. TS-OPTI-00799. 2023.

Fluid pathway during custom prime using albumin.

If you have a specific question about the Spectra Optia system, let us know. We will feature a reader question in each Access Point edition. Be sure to tell us your first name, hometown, and state or province. Questions not featured will be answered directly via email.

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Resource spotlight

> E-learning: Custom prime overview

This self-study learning module introduces you to the principles of custom prime in less than 1 hour. You can also download a transcript of the tutorial.

Did you know?

Tubing set plays a role in optimal extracorporeal volume

Having the right ECV in the disposable tubing set is necessary to establish and maintain the interface during a procedure on Spectra Optia. That volume varies based on the tubing sets and fillers used (see Table 1).

The Spectra Optia system uses the maximum ECV listed in the table for all calculations that trigger a custom prime recommendation. Note that the values listed in the table do not include the ECV for blood warmer tubing or other accessory tubing. To accurately calculate the total ECV in these situations, add the ECV of the accessory tubing to the ECV of the disposable tubing set.

To ensure the set has been adequately primed with red blood cells or albumin, process 200 mL of custom prime fluid for procedures using the Exchange Set and 300 mL for procedures using the IDL Set. This will allow approximately 95% of the saline in the tubing set to be removed. A volume less than these values is not optimal.

Events

Live From Lakewood

Key Performance Indicator (KPI) Dashboard Overview | January 15, 2026

All Live From Lakewood sessions are scheduled for 12 p.m. MT. Learn more and register to attend any of these live and interactive webinar sessions from our headquarters in Lakewood, Colorado. If you would like to have a specific topic covered in one of these webinars, please send us an email.

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could help you make the most of your Spectra Optia system and your relationship with

Terumo Blood and Cell Technologies to do even more for your patients.

Spectra Optia™ is either a registered trademark or trademark of Terumo BCT, Inc. in the United States and/or other countries. See TerumoBCT.com/Trademarks for details.

Intended Use

The Spectra Optia Apheresis System, a blood component separator, may be used to perform the following therapeutic apheresis, cell collection, and cell processing procedures:

• Therapeutic plasma exchange

• Red blood cell exchange, depletion, and depletion/exchange for the transfusion management of sickle cell disease in adults and children

• Mononuclear cell collection from the peripheral blood

• Granulocyte collection from the peripheral blood

• White blood cell reduction for patients with leukocytosis at risk for leukostasis

• Processing of harvested bone marrow for the purpose of facilitating hematopoietic reconstitution