Plasmapheresis

by Sam Malone


Plasmapheresis is a medical procedure adopted for the treatment of various autoimmune diseases. The steps involved in this complex process include:

  • Withdrawing blood from a person's body
  • Removing and replacing the plasma or liquid portion of the blood
  • Transfusing the blood, along with all its white & red blood cells back into the body

Medical experts describe plasmapheresis as an extracorporeal therapy process (a medical process performed outside the body). Doctors usually recommend this procedure for patients suffering from autoimmune diseases such as:

  • Goodpasture's Syndrome
  • Grave's Disease (In infants)  
  • Guillain Barre Syndrome
  • Lupus
  • Miller Fisher Syndrome
  • Multiple Sclerosis
  • Myasthenia Gravis
  • Thrombotic Thrombocytopenic Purpura

Plasmapheresis gets rid of the antibodies that become active in the blood because of these illnesses.

During the actual procedure, a needle or catheter is used for extracting the blood. A cell separator then removes the plasma from the blood. There are three ways in which plasma is separated from the blood and these are:

  1. Discontinuous Flow Centrifugation: A single venous catheter line is used during this procedure. Normally, blood is extracted in batches of 300ml at a time and is centrifuged to remove the plasma.
  2. Continuous Flow Centrifugation: While performing this procedure doctors use two venous catheter lines. In this method, a smaller volume of blood is extracted at a time, since the body can spin out plasma continuously.
  3. Plasma Filtration: This method requires the use of two venous catheter lines and standard hemodialysis equipment is used to filter the plasma. Less than 100ml of blood needs to be taken out of the body at one time.

There are pros and cons associated with each method and the doctor will recommend one that is suited to your needs. In each of the methods though, the plasma-free blood is returned to the body. The plasma containing antibodies is then treated before being returned to the body too. In a Plasma Exchange process, your plasma may be discarded as you may receive replacement donor plasma or other fluids like albumin or saline. Common risks associated with this procedure include:

  • Excess bleeding
  • Lung punctures
  • Infection
  • Formation of blood clots
  • Hypotension
Fortunately, simple preventative measures can be taken to reduce the risks of these complications. Speak to your doctor about the dos and don'ts that need to be followed before and after the procedure. 
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