What is Plasmapheresis?

Plasmapheresis is the procedure that is done to exchange the plasma present in the blood with fresh plasma substitute or plasma from a donor. Plasmapheresis or plasma exchange process broadly involves the following steps:

• Whole blood is taken out from the person’s body.
• The liquid part, or plasma, is separated from the blood that contains white blood cells and replaced with fresh plasma substitute or plasma from the donor.
• The replaced plasma, along with the patient’s blood, is transfused back into the body.

When is a plasmapheresis performed?

This procedure may be recommended as a primary or secondary line of treatment if either of the following conditions is present: 

• Autoimmune diseases such as Guillain-Barré syndrome and Myasthenia gravis
• Thrombotic thrombocytopenic purpura 
• Fulminant Wilson disease
• Hyper viscosity syndrome
• Hemolytic uremic syndrome
• Hyper-triglyceridemic pancreatitis 
• RBC alloimmunization during pregnancy 

Plasmapheresis removes the circulating auto-antibodies present in the blood. The autoantibodies may sometimes attack and damage the body’s own tissues and cells. The procedure is also used to remove metabolic substances and toxins from the blood.

How is Plasmapheresis done?

• Blood is withdrawn from the patient’s body to the apheresis machine through one of the catheter tubes. After the blood enters the machine, the blood cells will be segregated from the plasma.
• The machine works in two ways:
  • In the first process, the blood cells will be segregated from the plasma by rotating the blood at a very high speed (centrifugation).
  • In the second process, the blood cells get segregated from the plasma by a special membrane. The membrane has tiny pores that filter the plasma by leaving behind the blood cells.
• The blood cells will then reconstitute with the plasma substitute or donor plasma. The new reconstituted blood is then transfused back into the person’s body through another catheter tube.

A single plasmapheresis treatment will last for about 1-3 hrs. The length of the procedure depends on the patient’s body size and the amount of plasma that is required to be exchanged. The patient should take appropriate rest for a short period after the treatment. The patient may require 2-3 treatments per week.

What are the precautions that need to be taken after the procedure?

• Notify the doctor if you have symptoms like seizures, irregular heartbeat, abdominal pain, wheezing, chest pain, shortness of breath, nausea/vomiting, fever, chills, fainting, joint pain with fatigue, and excessive itching or rashes. 
• Take enough rest and drink plenty of fluids.
• Take a well-balanced diet as suggested by the physician.