Yazhini Selvaraj: What is Plasmapheresis?
Yazhini Selvaraj, Medical Student at Vinayaka Mission’s Research Foundation – University, shared a post on LinkedIn:
“Plasmapheresis
Definition
Therapeutic Plasma Exchange (TPE) is a procedure in which a patient’s blood is removed, plasma is separated and discarded, and the cellular components are returned along with replacement fluids such as albumin or plasma.
Indications
1.Autoimmune diseases
- Myasthenia Gravis
- Guillain-Barré Syndrome
- Systemic Lupus Erythematosus
2.Hematological disorders
- Thrombotic Thrombocytopenic Purpura
3.Others
- Hyperviscosity syndrome
- Severe drug toxicity
- Organ transplant rejection
Contraindications
- Severe hemodynamic instability
- Lack of vascular access
- Severe hypocalcemia (especially with citrate use)
- Allergy to replacement fluids (FFP/albumin)
- Uncontrolled sepsis (relative)
Duration of Procedure
Usually 2–4 hours per session
Number of sessions:
- Depends on disease (often 3–5 sessions or more
Procedure
1. Blood withdrawal (Arterial line)
- Blood is taken from the patient through an arterial line.
- An anticoagulant (usually Heparin or citrate) is added to prevent clotting in the circuit.
2. Pumping system
- A pump moves the blood through the extracorporeal circuit at a controlled rate.
3. Plasma separator (Filter/Centrifuge)
Blood enters a plasma separator:
Separates into:
- Plasma (liquid part – contains antibodies, toxins, proteins)
- Cells (RBCs, WBCs, platelets)
- Mechanism can be filtration or centrifugation.
4. Plasma removal
- The separated plasma is discarded or collected (shown as ‘plasma collection’).
- This removes harmful substances (e.g., autoantibodies, immune complexes).
5. Replacement fluid
- Lost plasma volume is replaced with:
- Colloids (e.g., albumin)
- Sometimes fresh frozen plasma (FFP)
- This maintains blood volume and oncotic pressure.
6. Return of blood cells
- Red blood cells and other cells are returned to the patient.
- An air bag/chamber helps push the blood safely and prevent air embolism.
7. Heating and return (Venous line)
Blood passes through a heater to maintain body temperature.
Finally, it returns to the patient via the venous line.”
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