Plasmapheresis – Interesting Facts

Plasmapheresis

Plasmapheresis is a procedure to remove blood from your body and separate the liquid part of your blood (plasma) from your blood cells.

The plasma is separated in a machine, and then it is replaced with donor plasma or a plasma substitute.

Your blood cells and the new plasma are then returned to your body.

This procedure is also called plasma exchange.

5 Interesting Facts of Plasmapheresis

1. Plasmapheresis can be effective in removing large toxins and pathogenic antibodies when combined with immunosuppression.

2. Plasmapheresis is the treatment of choice in patients with TTP, anti-GBM disease (without advanced kidney failure), and hemoptysis from ANCA or anti-GBM disease.

3. Plasmapheresis may be beneficial in ANCA disease with advanced kidney failure.

4. There is no current indication for plasmapheresis in patients with lupus nephritis.

5. Indications for plasmapheresis in kidney transplant are ABO-incompatible kidney transplantation, recurrent FSGS, and acute humoral rejection.

You may need plasmapheresis if you have:

  • A condition that causes your body’s immune system to attack its own tissues (autoimmune disease).
  • Certain conditions of the brain and nervous system.
  • Harmful substances in your blood.

How often you need to have these treatments will depend on your illness.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.
  • Any current or recent fever or other signs of infection.
  • Whether you are pregnant or may be pregnant.

What are the risks of Plasmapheresis?

Generally, Plasmapheresis is a safe procedure. However, problems may occur, including:

  • Allergic reactions.
  • Infection.
  • Bleeding.
  • A drop in blood pressure.
  • A drop in body temperature.

What happens before the Plasmapheresis procedure?

  • Ask your health care provider about changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • You may have an exam or testing.
  • The day before the procedure:
    • Do not drink any beverages that have caffeine or alcohol in them. Caffeine and alcohol cause you to lose fluids.
    • Drink enough of other fluids to keep your urine pale yellow. This prevents your blood pressure from dropping.
  • The day of the procedure:
    • Make sure you eat a meal prior to the procedure.
    • Bring a list of all the medicines you are taking. Give it to your health care provider before the procedure.
    • You will be asked to empty your bladder by urinating before the procedure starts.
    • Your height and weight will be measured.
    • You may have a blood sample taken.
    • If needed, medicine may be given to prevent an allergic reaction.
  • Plan to have someone take you home from the hospital or clinic.

What happens during the Plasmapheresis procedure?

  • You will sit or lie in a bed or on a chair. You will be awake during this procedure.
  • You may be given a medicine to numb the area (local anesthetic).
  • IV lines will be inserted into two of your veins.
  • You may be given medicines that keep your blood from clotting during the procedure.
  • Blood will be removed from your body through one of the IVs. The blood will pass through a machine that filters out part of the plasma. Blood with donor plasma or plasma substitute will be returned to your body through the other IV.
  • Your blood pressure, heart rate, temperature, and breathing will be monitored during the procedure.
  • A warming blanket may be placed over you to keep you from feeling cold.
  • You may feel light-headed at times. Let your health care providers know if you experience:
    • Nausea.
    • Chills.
    • Tingling.
    • Dizziness.
    • Cramps.
    • Blurred vision.
  • The procedure may take up to 4 hours to complete.
  • Your IV lines will be taken out after the plasma exchange is complete.
  • Pressure may be applied to the IV sites for a few minutes to stop any bleeding.
  • The IV sites will be covered with bandages (dressings).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your blood pressure, temperature, pulse, and breathing will be monitored until you leave the hospital or clinic.
  • You may have blood samples taken.
  • You will be able to go home after a short period of rest and observation.
  • You may have some bruising and soreness at your IV sites.
  • For several hours after the procedure, you may bleed more easily. You should be careful to avoid getting cut or injured during this time.

Summary

  • Plasmapheresis is a procedure to remove blood from your body and separate the liquid part of your blood (plasma) from your blood cells.
  • The plasma is separated in a machine. It is replaced with donor plasma or a plasma substitute.
  • Your blood cells and the new plasma are then returned to your body.
  • You may need this procedure if you have an autoimmune disease, have harmful substances in your blood, or have certain conditions of the brain and nervous system.

Care Instructions after Plasmapheresis

Here is the information about how to care for yourself after your Plasmapheresis procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

  • Tiredness (fatigue).
  • Soreness and bruising at your IV insertion sites.
  • Bleeding more easily during the first several hours after your procedure.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Talk with your health care provider before you take any medicines that contain aspirin or NSAIDs. These medicines increase your risk for dangerous bleeding.

Activity

  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Take steps to avoid things that may cause bleeding. Medicine that is used during the procedure slows down blood clotting. This increases the risk for bleeding if you cut or injure yourself.
  • Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers.

General instructions

  • Change or remove your dressing as told by your health care provider.
  • Check your IV insertion sites every day for signs of infection. Check for:
    • Redness, swelling, or pain.
    • Fluid or blood. If fluid or blood drains from your IV site, use your hands to press down firmly on a bandage covering the area for a minute or two. Doing this should stop the bleeding.
    • Warmth.
    • Pus or a bad smell.
  • Drink enough fluid to keep your urine pale yellow.
  • Keep all follow-up visits as told by your health care provider. This is important. Follow-up visits include any visits for additional plasmapheresis treatments.

Contact a health care provider if you have:

  • Signs of infection at your IV site.
  • Any unusual bruising or bleeding.
  • Unusual tiredness or weakness.
  • Nausea or vomiting.

Get help right away if:

  • You have a fever or chills.
  • Hives, rash, or itching.
  • Have pain in your abdomen.
  • You have bleeding that does not stop.
  • You start to wheeze or cough.
  • You have trouble breathing.
  • You have chest pain.

Summary

  • After the Plasmapheresis procedure, it is common to have fatigue and soreness or bruising at IV insertion sites.
  • Medicine used during the procedure slows down blood clotting, so you may bleed more easily for a few hours after the procedure. Be careful not to cut or injure yourself during this time.
  • Check your IV insertion sites every day for signs of infection. Contact your health care provider if you have questions or unusual symptoms.
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