(Plasma Exchange; Therapeutic Plasma Exchange)
Plasmapheresis is done to exchange plasma in the blood. Plasma is the liquid part of the blood that does not contain cells. After the plasma is removed, fresh plasma or a plasma substitute is added back to the blood.
Reasons for Procedure ^
Plasmapheresis removes autoantibodies from the blood. Autoantibodies are proteins found in plasma. They mistakenly attack your body’s own tissues. In some cases, this procedure is used to remove toxins or metabolic substances from the blood.
Plasmapheresis is used to treat the following:
- Autoimmune diseases
- Neurological diseases
- Very high levels of cholesterol that are not reduced by diet and medications
- Toxins that can get into your blood
Possible Complications ^
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like
- Anaphylaxis—a dangerous allergic reaction to the solutions used in plasma replacement, which usually starts with itching, wheezing, or a rash
- Mild allergic reaction to the procedure, such as fever, chills, or rash
- Drop in blood pressure
- Bruising or swelling
Plasmapheresis may not be appropriate for people with certain clotting disorders. Talk to your doctor about your current health level.
What to Expect ^
Prior to Procedure
Leading up to your procedure:
- Review your regular medications with your doctor. You may be asked to stop taking some medications up to 1 week before the procedure.
- Arrange to have someone drive you home from the hospital.
- Drink plenty of non-caffeinated and non-alcoholic beverages.
The day of your treatment:
- Eat a well-balanced meal before going for treatment, unless instructed otherwise by your doctor.
- Wear comfortable clothing with sleeves that can easily be pulled above the elbows.
Anesthesia is not needed for this procedure.
Description of the Procedure
You will be asked to lie in a bed or sit in a reclining chair. 2 needles attached to a catheter tube will be inserted into veins. In some cases, a needle will be inserted into each arm. For others, 1 needle may be inserted into your arm and the other into the opposite foot. If the veins in your limbs are too small to use, a long-duration catheter will be inserted. It will be placed in a vein in your shoulder or groin area.
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Blood will be taken out of your body through 1 of the catheter tubes. It will then go into the apheresis machine. Once in the machine, the blood cells will be separated from the plasma. The machine works in one of 2 ways. In the first method, the blood cells may be separated from the plasma by spinning the blood at high speeds. The second method uses a special membrane. The membrane has tiny pores that only the plasma can pass through, leaving the blood cells behind. The blood cells will be mixed with replacement plasma or a plasma substitute. The new mixed blood will then be returned to your body through the other tube.
Immediately After Procedure
You will be asked to rest for a short period of time.
How Long Will It Take?
- A single plasmapheresis treatment can take 1 to 3 hours.
- The length of treatment will depend on your body size and the amount of plasma that needs to be exchanged.
- You will most likely need to have several treatment sessions per week for 2 weeks or more.
- The frequency of your treatments will depend on your diagnosis.
How Much Will It Hurt?
You may experience some discomfort when the needles are inserted. The procedure itself is painless.
Average Hospital Stay
- The procedure is usually done outside of the hospital. In such cases, you will be allowed to leave after a short resting period.
- In some instances, hospitalization is required. Length of stay will depend on your diagnosis.
When you return home, be sure to follow your doctor's instructions.
Improvement can occur within days or weeks, depending on the condition being treated. Benefits usually last for up to several months, but may last longer. Over time, autoantibodies may again be produced by your body. Because of this, plasmapheresis is mainly used as a temporary treatment.
Call Your Doctor ^
Call your doctor if any of the following occurs:
- Excessive bruising, bleeding, or swelling at the needle insertion sites
- Signs of infection, including fever and chills
- Excessive itching or rash
- Nausea and/or vomiting
- Feeling lightheaded, or fainting
- Severe pain
- Cough, wheezing, shortness of breath, or chest pain
- Irregular heartbeat
- Abdominal pain
- Joint pain, fatigue, stiffness, or other new symptoms
If you think you have an emergency, call for emergency medical services right away.
Muscular Dystrophy Association
Myasthenia Gravis Foundation of America
Canadian Hemophelia Society
Muscular Dystrophy Canada
Facts about plasmapheresis. Muscular Dystrophy Association website. Available at: http://static.mda.org/publications/PDFs/FA-Plasmapheresis.pdf. Updated July 2005. Accessed June 21, 2016.
Myasthenia gravis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 22, 2015. Accessed June 21, 2016.
Plasmapheresis. Myasthenia Gravis Foundation of America, Inc. website. Available at: http://www.myasthenia.org/LivingwithMG/InformationalMaterials.aspx. Accessed June 21, 2016.
Plasmapheresis. Myasthenia Gravis Association of Western Pennsylvania website. Available at: http://www.mgawpa.org/pdfs/PlasmapheresisLH.pdf. Published 1993. Accessed June 21, 2016.
Last reviewed June 2016 by Marcin Chwistek, MD Last Updated: 5/29/2015