Plasmapheresis

Feature Summary

  • Immune disorders, such as lupus with central nervous system involvement, myasthenia gravis crisis, Guillain–Barré syndrome, multiple sclerosis, Goodpasture syndrome, hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, granulomatosis with polyangiitis, antiphospholipid antibody syndrome (APS or APLS), microscopic polyangiitis
  • Familial homozygous hypercholesterolemia
  • Hyperviscosity syndromes: cryoglobulinemia, paraproteinemia, Waldenström macroglobulinemia
  • Recurrent focal and segmental glomerulosclerosis in the transplanted kidney.

 

Overview

Plasmapheresis (PP) is the removal, treatment, and return or exchange of blood plasma or components thereof from and to the blood circulation.

Two general types of plasmapheresis can be distinguished:

  • Removing blood plasma, treating it in some way, and returning the blood cells to the same person
  • Removing blood plasma and exchanging it with blood products (donor plasma or albumin) to the recipient; this type is called plasma exchange (PE)

 

Features

  • Removal of harmful antibodies or toxins
  • Removal of excessive metabolic wastes (such as cholesterol)
  • Lowering the viscosity of the blood

 

Procedure

  1. A double-lumen catheter is usually implanted via femoral vein (near the inguinal area).
  2. During plasmapheresis, blood is initially taken out of the body through the catheter.
  3. Plasma is then removed from the blood by a cell separator.
  4. After plasma separation, the blood cells are returned to the person undergoing treatment, while the plasma will then be returned to the patient after the removal of the harmful antibodies.
  5. Medication, such as an anticoagulant to keep the blood from clotting, calcium to prevent cramping, and a steroid or anti-histamine for allergies, will be given to the patient during the procedure.
  6. The treatment time for this procedure usually takes about 2 hours.

 

Notification

  • Bleeding over the site of the implanted large intravenous catheter
  • Infection, if the catheter is left in too long
  • Blood loss due to blood clotting when the patient’s blood is outside of the body passing through the plasmapheresis machine
  • Muscle cramping due to hypocalcemia (low serum calcium concentration) may occur, because of the binding of calcium in the blood by citrate, which is contained in the donated plasma products as anti-coagulants; this can be prevented by the infusion of calcium intravenously during PP
  • Hypotension
  • Transfusion reactions or transfusion-transmitted diseases

 

Estimated Cost

Prices are subject to change without prior notice, need to pay in accordance with the actual medical expenses.