What Is Plasmapheresis?
Plasmapheresis is a scientific procedure where the blood plasma is segregated from the blood cells. In particular, another solution, such as saline or albumin, is used to replace plasma or the plasma is treated externally and then returned to the body.
If the patient is sick, antibodies in their plasma may attack the immune system. The affected plasma is then replaced by a machine with good plasma or a plasma substitute. This procedure is also known as plasma exchange.
Plasmapheresis can also be referred to as the process of donating plasma. Here, the blood plasma is removed from the patient’s body, and the blood cells are returned to the body.
When Plasmapheresis Is Required?
Plasmapheresis is a medical procedure that is usually preferred to manage various chronic autoimmune disorders, including:
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Myasthenia gravis (a neuromuscular autoimmune disease that causes weakness in the skeletal muscles).
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Guillain-Barre syndrome (a rare condition where the body's nerves are attacked by the body’s immune system).
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Chronic inflammatory demyelinating polyneuropathy (a rare condition characterized by the inflammation of the nerve roots and peripheral nerves).
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The procedure can also be used to manage certain complications of sickle cell anemia.
The body has produced antibodies (proteins) programmed to identify cells in these disorders and destroy them. These antibodies are present in the blood plasma. However, in normal conditions, these antibodies are directed at foreign antigens, such as a virus, that may cause damage to the body. Plasmapheresis is implicated in stopping this process by replacing the affected plasma containing antibodies with the new plasma.
The therapy is also used to treat patients who are severely ill with fatal infections and other disorders, such as Wilson’s disease (a disease characterized by excessive copper accumulation in the organs) and thrombotic thrombocytopenic purpura (life-threatening blood disease where blood clots are formed in the small blood vessels throughout the body). Plasmapheresis has also been used in patients who have undergone organ transplants to counteract the natural rejection process of the body.
What Happens In Plasmapheresis Therapy?
During this therapy, the patient will be made to lie down. A needle or catheter is inserted into a vein of the patient. The replaced or treated plasma flows into the body through a second tube attached to the arm or foot.
People can usually donate plasma up to two times a week; the donation sessions are usually 90 minutes. The procedure usually lasts between one and three hours in the case of plasmapheresis therapy. As many as five treatments per week may be required by the patient. However, the treatment frequency varies widely from condition to condition and depends on the patient's overall health.
How To Prepare the Patient for Plasmapheresis?
To minimize the symptoms and risks of the procedure, the following measures should be taken;
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Patients should be provided with a nutritious, balanced diet before the therapy or plasma donation.
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Proper night's sleep before the procedure.
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Drink lots of fluids.
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Get vaccinated for common infections before undergoing therapy.
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Avoid smoking, tobacco, and alcohol consumption.
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The diet to be consumed should be rich in protein and low in phosphorus, sodium, and potassium before the procedure of plasmapheresis.
What Are the Advantages of Plasmapheresis?
The patient gets relieved after receiving plasmapheresis as a treatment for some serious infection or an autoimmune disease. However, plasmapheresis will only provide short-term symptomatic relief. The process needs to be repeated many times a week also. The frequency and outcome of the results largely depend on the patient's condition and the disease's severity. The healthcare professional will provide a general idea of plasmapheresis to the patient.
What Are the Risks and Complications of Plasmapheresis?
Plasmapheresis has got a few side effects. However, they are usually mild and rarely present. The most frequently found complication is a decrease in blood pressure. This symptom is usually accompanied by:
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Lightheadedness (faintness).
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Impaired vision for a few weeks (blurry).
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Dizziness (vertigo).
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Feeling cold.
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Abdominal cramps.
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Risk of encountering serious infections.
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Blood coagulation (the doctor usually prescribes anticoagulants to prevent this risk).
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Hypersensitivity reaction (allergic reactions).
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Profuse bleeding can be a more serious risk from consuming anti-coagulants.
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Tingling and numbness in the limbs.
Plasmapheresis is not advisable in patients including:
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People who are not stable hemodynamically.
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People who have allergies to heparin.
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People with hypocalcemia (reduced calcium levels in the serum).
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People who have allergies to frozen plasma or frozen plasma protein albumin.
Conclusion
Plasmapheresis is the therapeutic procedure of removing, treating, and returning or replacing blood plasma or components from and to the circulating blood of the person. Therefore, it is an extracorporeal therapy (a medical procedure performed outside the body). It is usually employed to lower the concentration of immune complexes or decrease the titer of autoantibodies that may cause damage to several body organs. Research and efforts are being made to make this medical procedure a useful adjunct to chemotherapy for removing immunoglobulin proteins in tumors like multiple myeloma.
