(Plasma Exchange; Therapeutic Plasma Exchange)
Plasmapheresis is done to exchange plasma in the blood. Plasma is the liquid part of the blood. It doesn't have any cells. The plasma is removed. Then, fresh plasma or a plasma substitute is added back to the blood.
Reasons for Procedure
Plasmapheresis takes out certain proteins from the plasma. They're called autoantibodies. They mistakenly attack your body’s own healthy cells. In some cases, it's used to take out toxins or other substances from the blood.
Plasmapheresis is used to treat:
- Immune system problems
- Nervous system problems
- Very high levels of cholesterol that aren't controlled by other methods
- Toxins in the blood
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review possible problems such as:
- Reactions to the plasma—they range from mild to serious
- Drop in blood pressure
- Bruising or swelling
This may not work well for people who have certain blood clotting problems. Talk to your doctor about any problems you may have.
What to Expect
Prior to Procedure
Leading up to your procedure:
- Talk to your doctor about all the medicines you take. You may need to stop take certain medicines up to 1 week in advance.
- Arrange to for a ride.
- Drink plenty of fluids. Avoid caffeine and alcohol.
The day of your treatment:
- Follow any special meal requests from your doctor before your procedure.
- Wear comfortable clothing with sleeves that can easily be pulled above the elbows.
Anesthesia is not needed for this procedure.
Description of the Procedure
Two needles attached to a tube will be placed into veins. They may be placed in different parts of the body. A long duration catheter will be inserted if the veins are too small. It will be placed in the shoulder or groin area.
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Blood will be taken out of the body through one of the tubes. It will then go into a special machine. The machine separates the blood and plasma. In one method, the blood cells may be separated from the plasma by spinning it at high speeds. Another method uses a special membrane. The membrane has tiny pores that only the plasma can pass through. This leaves blood cells behind. The blood cells are mixed with fresh plasma or a plasma substitute. The new mixed blood will then be returned to the 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 time will depend on your body size and the amount of plasma that needs to be exchanged.
- You may need to do this more than once.
- The frequency will depend on your diagnosis.
How Much Will It Hurt?
You may feel a sting when the needles are inserted.
Average Hospital Stay
You will be able to leave the same day. Once you rest and you are cleared, you can go home. If you have problems, you may need to stay longer.
You may feel better within days or weeks. It depends on the problems you were having. Your doctor will let you know how often you will need to have this done.
Call Your Doctor
Call your doctor if any of these occur:
- Excess bruising, bleeding, or swelling at the needle insertion sites
- Fever or chills
- Itching or rash
- Nausea or vomiting
- Feeling lightheaded or fainting
- Severe pain
- Cough, wheezing, breathing problems, or chest pain
- Irregular heartbeat
- Belly pain
- Joint pain, fatigue, or stiffness
If you think you have an emergency, call for emergency medical services right away.
Muscular Dystrophy Association
Myasthenia Gravis Foundation of America
Canadian Hemophilia Society
Muscular Dystrophy Canada
Myasthenia gravis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T113873/Myasthenia-gravis. Updated September 19, 2017. Accessed August 21, 2018.
Plasmapheresis. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/transplant/programs/kidney/incompatible/plasmapheresis.html. Accessed August 21, 2018.
Plasmapheresis. Myasthenia Gravis Foundation of America, Inc. website. Available at: http://www.myasthenia.org/LinkClick.aspx?fileticket=1BtivQfbFNM%3d&tabid=84. Accessed August 21, 2018.
Plasmapheresis. National Multiple Sclerosis Society website. Available at: https://www.nationalmssociety.org/Treating-MS/Managing-Relapses/Plasmapheresis. Accessed August 21, 2018.
Last reviewed May 2018 by EBSCO Medical Review Board Marcin Chwistek, MD Last Updated: 8/21/2018