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Yazhini Selvaraj: What is Plasmapheresis?
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Apr 29, 2026, 02:04

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.”

Yazhini Selvaraj

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