Why Would You Need Plasmapheresis?

Reviewed on 1/28/2021

What is plasmapheresis?

Plasmapheresis treats autoimmune diseases, toxins in the blood, neurological diseases, and very high levels of cholesterol that don't lower with medications or dietary changes.
Plasmapheresis treats autoimmune diseases, toxins in the blood, neurological diseases, and very high levels of cholesterol that don't lower with medications or dietary changes.

Plasmapheresis removes antibodies against the person's own body cells and tissues (autoantibodies) from the blood. Autoantibodies are proteins found in the plasma. They mistakenly attack the body's own tissues. In some cases, this procedure is used to remove toxins or metabolic substances from the blood. Plasmapheresis is used to treat the following:

  • Autoimmune diseases
  • Neurological diseases
  • Very high levels of cholesterol that are not reduced by diet and medications
  • Toxins that can get into your blood

In plasmapheresis, the liquid part of the blood, called the plasma, is separated from the blood cells. During this process, normal saline or albumin replaces the plasma, and then the cleaned plasma is replaced into your body. In a process very similar to dialysis, the plasma can be removed from the body to cleanse it to treat various types of disorders.

Procedure:

  • A medical professional asks the patient to lie on a bed or sit on a reclining chair.
  • For plasmapheresis, the doctor takes blood from the patient's body using large-bore needles in the limb veins (usually the arms) or an implanted catheter in the internal jugular veins (large veins of the neck), subclavian veins or axillary veins (large veins of the chest), or femoral veins (large veins of the groin). If they use a catheter, they must insert it under local anesthesia or light sedation beforehand.
  • The doctor takes the blood from the patient's body through one of the catheter tubes. They will then place the tubes into the apheresis machine.
  • The blood cells get separated from the plasma in the machine. The machine works in one of the two ways:
    • In the first method, the blood cells may be separated from the plasma by spinning the blood at high speeds.
    • The second method uses a special membrane. The membrane has tiny pores that only the plasma can pass through, leaving the blood cells behind.
  • The doctor mixes the blood cells with the replacement plasma or a plasma substitute. They return the new mixed blood to the patient's body through the other tube.
  • After removing the plasma, the doctor returns the remaining blood to the patient along with a plasma replacement, such as albumin or an albumin and saline mixture.
  • During one session, the doctor may remove 3-4 L of plasma. A single plasmapheresis session may be effective, although it is more common to have several sessions in 1 or 2 weeks.
  • The length of treatment will depend on the patient's body size and amount of the plasma that needs to be exchanged.
  • A single plasmapheresis treatment can take 1-3 hours.
  • The procedure itself is painless, however, the patient may experience some discomfort when the needles are inserted.
  • The procedure is usually done on an outpatient basis, and the patient may be allowed to leave after a short resting period. In some instances, hospitalization is required. The length of stay will depend on the diagnosis and complications.
  • Improvement can occur within days or weeks, depending on the condition being treated. Benefits usually last for up to several months but may last longer. Over time, autoantibodies may again be produced by the body. Because of this, plasmapheresis is mainly used as a temporary treatment.

Risks of plasmapheresis:

How do people prepare for plasmapheresis?

Plasmapheresis is a simple procedure, however, some care may be taken to avoid any complications.

  • Eat a diet high in protein and low in sodium, potassium, and phosphorous a few days before treatment.
  • Get a good night's sleep the night before treatment.
  • Eat a nutritious meal and drink plenty of fluids the morning before treatment.
  • Make sure your vaccinations are up to date.
  • Avoid smoking.

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References
Stieglitz, Elliot. "Plasmapheresis." Medscape.com. Dec. 4, 2019. <https://emedicine.medscape.com/article/1895577-overview>.

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