(Plasma Exchange; Therapeutic Plasma Exchange)
Plasmapheresis is a procedure to exchange plasma in the blood. Plasma is the liquid part of the blood. It does not 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. These proteins mistakenly attack the body’s own healthy cells. This procedure also takes out toxins or other substances from the blood.
Plasmapheresis is used to treat:
- Immune system problems
- Nervous system problems
- Very high levels of cholesterol—not controlled by other methods
- Certain blood problems
- Toxins in the blood
- Certain severe infections
Problems are rare, but all procedures have some risk. The doctor will go over problems that could happen, such as:
- Reactions to the plasma—from mild to serious
- Bleeding, bruising, or swelling
- A drop in blood pressure
What to Expect
Prior to Procedure
The doctor may talk to you about:
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before the procedure
- Whether you need a ride to and from the procedure
- Drinking lots of fluids before the procedure
- What you should (and should not) eat and drink before the procedure
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 cells and plasma. The blood cells are then mixed with fresh plasma or a plasma substitute. The new mixed blood will then be returned to the body through the other tube.
How Long Will It Take?
- A single treatment can take 1 to 3 hours.
- The length of time depends on body size. It also depends on the amount of plasma that needs to be exchanged.
- This treatment may need to be done more than once. It depends on the condition being treated.
Will It Hurt?
There may be a sting when the needles are inserted.
Average Hospital Stay
Most can go home the same day. If there are 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 you are not feeling better or you have:
- Excess bruising, bleeding, or swelling at the insertion sites
- Fever or chills
- Lightheadedness, fainting, or seizures
- Itching or rash
- Nausea or vomiting
- Severe pain, belly pain, or joint pain or stiffness
- Breathing problems or chest pain
- Fast, slow, or uneven heartbeats
If you think you have an emergency, call for medical help right away.
Muscular Dystrophy Association
Myasthenia Gravis Foundation of America
Canadian Hemophilia Society
Muscular Dystrophy Canada
Myasthenia gravis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/myasthenia-gravis. Accessed September 30, 2021.
Plasmapheresis. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/transplant/programs/kidney/incompatible/plasmapheresis.html. Accessed September 30, 2021.
Plasmapheresis. National Multiple Sclerosis Society website. Available at: https://www.nationalmssociety.org/Treating-MS/Managing-Relapses/Plasmapheresis. Accessed September 30, 2021.
Therapeutic plasma exchange. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/therapeutic-plasma-exchange. Accessed September 30, 2021.
Walters G. Role of therapeutic plasmapheresis in ANCA-associated vasculitis. Pediatr Nephrol. 2016;31(2):217-25.
Last reviewed July 2021 by EBSCO Medical Review Board Marcin Chwistek, MD Last Updated: 9/30/2021