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What Is Plasma Exchange Plasmapheresis?

A bag of blood plasma.
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  • Written By: Jacquelyn Gilchrist
  • Edited By: O. Wallace
  • Last Modified Date: 05 July 2014
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Plasma exchange plasmapheresis is a procedure that filters the plasma out of a person's blood in order to treat a variety of medical conditions. Blood is composed of platelets, plasma, and red and white blood cells. Plasma, which is a yellow fluid, is responsible for transporting proteins and assisting with the circulation of blood cells. It is the part of the blood that is fluid. This medical procedure removes a certain amount of blood from the body, separates it to filter out the plasma, and then returns the blood to the body.

A doctor may recommend that a patient undergo plasma exchange plasmapheresis, often just called plasmapheresis, to treat medical conditions like Guillain-Barre syndrome, Lambert-Eaton syndrome, and myeloma. This process treats these conditions by reducing the amount of proteins in the blood, called immunoglobulin. When a patient has abnormally high levels of these proteins, the blood becomes too thick.

The number of treatments may vary, but many patients may undergo six to 10 plasmapheresis sessions over the course of two to 10 weeks. Plasma exchange plasmapheresis is performed by a machine called a cell separator. A doctor will insert a needle into a vein in each of the patient's arms and connect them to the cell separator. Blood is removed from one needle, processed in the cell separator, and then returned to the body through the other needle. The entire process often takes approximately two hours, because only a small amount of blood is outside the patient's body at a time.

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While undergoing plasma exchange plasmapheresis, some patients may feel lightheaded or faint. This can be addressed by providing fluids and changing position. Those who feel faint during treatment should eat regular meals on the day of treatment. Plasmapheresis may also cause numbness in the fingers or around the mouth and nose. Patients should inform the nurse if they experience this so that the treatment can be halted briefly or the patient can be given a calcium-rich drink to counteract this side effect.

After the procedure is complete, patients should have someone else drive them home. Fatigue is common, so patients should plan to rest. They should consume plenty of fluids and avoid alcoholic beverages. Many patients will notice an improvement in their medical condition within days or a few weeks of beginning treatment.

Before undergoing plasma exchange plasmapheresis, patients should discuss the possible risks with their doctors. Blood clotting problems and infections may rarely occur. Some people may suffer from an allergic reaction during the procedure, which typically presents with wheezing, itching, and a rash. Patients may also have a suppressed immune system, so they should take care to avoid contact with people who are sick.

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