Plasmapheresis


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Plasmapheresis is the operation that cycles the blood out of a patient's body to remove plasma and returns the blood, with all its red and white blood cells, back into the patient to treat a number of disorders.

Description


This procedure is designed to filter plasma from the bloodstream via various centrifuge techniques in order to extract harmful antibodies from the patient. Using a IV unit, the blood is fed into a cell separator that separates the plasma from the red blood cells. The blood can also be sent through porous membrane that only the plasma is able to pass through. The plasma, containing the autoantibodies, is collected and properly discarded. The blood cells are then mixed into a new solution of either saline and albumin combination, a readied plasma donation, or a plasma substitute. The new blood combination is then distributed into the body through an IV. The purpose is to prevent malignant antibodies caused by autoimmune diseases, which reside in plasma, from causing more harm to the patient. Plasmapheresis procedures are also used to help patients with neurological disorders, blood toxins, and high levels of cholesterol.

Plasmapheresis Process
Plasmapheresis Process


This treatment however does not stop the underlining cause of the autoimmune disease. The treatment is designed to filter out the autoantibodies to give the body a chance to either replenish itself with good antibodies or to stall the progress of the autoimmune disease/neurological disorder until the next round of treatment.

Advancements


The first methods in carrying out plasmapheresis involved manually drawing out the blood and then treating it to be reintroduced back into the patient. Now there are automated centrifuges which draw out, seperate the plasma, introduce the plasma substitute and then reintregrate it back into the patient without any additional supervision. These machines add on an extra quality of safety in the procedure and boost the effectiveness.

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The above illustration is a representation of the other form of plasmaphersis. This method uses one, sometimes two, porous membranes. The membranes allow for only the plasma to pass through. There will sometimes be a second membrane if the the doctor wants to separate the plasma into two different categories, plasma that can not be re used and plasma that can.
While there are still certain side effects such as infection, bleeding and blood risk if donor blood is used, the applicable uses for Plasmapheresis are continuing to be expanded upon.

Applications


Plasmapheresis is commonly known to treat various autoimmune disorders, specifically because those disorders concern maligant antibodies which reside in blood plasma. Such are:
  • Guillain-Barre Syndrom
  • Wegeners Granulomatosis
  • HIV-related Neuropathy

In some cases Plasmapheresis has been known to help mitigate symptoms of Multiple Sclerosis.

Plasmaphersis is commonly used now to remove toxins in the blood that are currently incurable through drugs, mainly phalloid mushroom intoxication. This form of intoxication is very deadly, with around a 50% fatality rate. However, after plasmaphersis, the fatality rate dropped to 17.8%. Plasmaphersis is also used to remove drugs from the blood system. for various reasons, usually from treatments, not all of a drug is removed from the body. Through plasmaphersis the remaining drugs can be extracted and eliminated from the body. Finally, plasmaphersis is being used to remove protein heavy metals, such as mercury, from the bloodstream.

Related Terms

Autoimmune Disease
Plasma
Antibodies
Plasma Exchange

Web Resources

MedInstitute: Plasmapheresis
Facts About Plasmapheresis | MDA Publications
Current Status of Therapeutic Plasmapheresis and Related Techniques

References/Citations

MedInstitute: Plasmapheresis
Plasmapheresis: National MS Society
Current Status of Therapeutic Plasmapheresis and Related Techniques
http://ndt.oxfordjournals.org/content/18/suppl_5/v56.full