Plasmapheresis | Doctors & treatment information

Plasmapheresis is a medical method of collecting blood plasma from donors (plasma donation). Plasmapheresis is also used to remove components in the blood that cause diseases.

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Plasmapheresis - Further information

Blood plasma is a clear, yellowish liquid that makes up around 55 percent of all blood. The blood plasma itself consists of 91 percent water. The rest contains nutrients, hormones, minerals and more than 120 different proteins. Experts also refer to the total plasma in the blood as plasma volume.

Blood plasma is primarily a means of transport for metabolic products, hormones, glucose, lipids and carbon dioxide. Blood plasma transports metabolic waste products out of the body. Waste products are carbon dioxide, which the body excretes via the lungs, and various ureas.

BlutplasmaBlood plasma no longer contains blood cells @ arcyto /AdobeStock

What is preparative plasmapheresis?

Preparative plasmapheresis is a medical procedure used by specialists to obtain donor plasma (plasma donation).

The plasma is collected using plasmapheresis devices. Medical specialists insert a needle into the donor's vein. The donor is now connected to the plasmapheresis device. This separates the plasma from the remaining blood. To prevent the blood from clotting during this process, experts add citrate.

The donor then receives the returned blood cells. Inflowing cell water compensates for the donor's fluid loss.

The medical staff then freeze the collected plasma as quickly as possible. The donation takes around 30 to 70 minutes in total.

Plasma donation is less stressful than whole blood donation, as the donor loses less fluid (and red blood cells). The plasma regenerates within two days, which is why you can donate blood plasma much more frequently.

The proteins and proteins contained in the plasma are particularly important. The frozen plasma can be further processed for therapeutic purposes or for industry.

PlasmaspendeWomen and men are allowed to donate plasma a maximum of 60 times a year @ Seventyfour /AdobeStock

Areas of application for blood plasma donations are

  • Patients with coagulation disorders
  • Plasma exchange
  • Massive transfusions (exchange of the entire blood volume in 24 hours)
  • Industry: Here the blood plasma is used as a starting material for plasma derivatives such as human albumin solutions, coagulation factors and immunoglobulins.

    What is therapeutic plasmapheresis?

    Therapeutic plasmapheresis is an exchange treatment. Therapeutic plasmapheresis works in a similar way to plasma donation:

    Plasmapheresis devices separate the plasma from the remaining components of the blood. Specialists also distinguish between non-specific and specific plasma exchange.

    • Non-specific plasma exchange

    In non-specific plasma exchange, experts replace the removed plasma with a solution that simulates the body's own plasma. The substitution solution consists of electrolytes, buffer substances (hydrogen carbonate) and around five percent albumin or fresh plasma concentrates.

    • The specific plasma exchange

    In specific plasma exchange, only certain antibodies are extracted from the plasma. Experts also call this method immunoadsorption therapy. With this method, the loss of plasma is minimal.

    Treatment areas of therapeutic plasmapheresis

    Non-specific plasma exchange is used when plasma components are pathologically elevated or structurally altered.

    This may be the case in the following diseases

    • Thyrotoxic crisis (life-threatening hormone poisoning, usually associated with hyperthyroidism)
    • Waldenström's disease (also known as macroglobulinemia, a rare form of leukemia)
    • Schnitzler syndrome (combination of a skin disease, joint pain and increased antibodies)
    • Thrombotic thrombocytopenic purpura (TTP) (combination of platelet deficiency, anemia and central nervous symptoms)
    • Hepatopulmonary syndrome: disturbance of gas exchange in the pulmonary circulation with oxygen deficiency and dilation of the pulmonary vessels in the presence of liver disease
    • Haemolytic uraemic syndrome (HUS ): combination of acute kidney failure, platelet deficiency and dissolution of red blood cells in the smallest vessels

    Specific plasma exchange is mainly used in the treatment of autoimmune diseases.

    These include

    • Various forms of glomerulonephritis (inflammation of small nerve or vascular nodules in both kidneys)
    • Rheumatic diseases (for example rheumatoid arthritis)
    • Various neuroimmunological diseases (e.g. multiple sclerosis)
    • Goodpasture syndrome (attack and destruction of alveoli and basement membrane of the kidney)
    • Myasthenia gravis (muscle weakness due to a neuromuscular transmission disorder)
    • Lupus-associated complications (for example antiphospholipid syndrome, an increased tendency to thrombosis due to changes in blood components)
    • Autoimmune hemolytic anemia (dissolution of red blood cells by antibodies)

    Complications of plasmapheresis

    Overall, plasmapheresis is a procedure with few complications.

    However, the following complications can occur:

    • Bruising, infections or nerve injuries at the injection site
    • Inflammation or damage to the punctured blood vessel
    • Reaction to citrate: During plasmapheresis, the citrate prevents the blood from clotting until it is back in the body. Although the body breaks down the citrate quickly, a short-term acute calcium deficiency may occur. A calcium deficiency is noticeable through shivering and a tingling sensation in the tongue, fingertips and toes. If the calcium deficiency remains untreated, it can lead to cardiac arrhythmia, which can be life-threatening under certain circumstances. For this reason, those affected should report any symptoms immediately. After taking calcium, the reactions should subside.
    • Circulatory disorders: For this reason, those affected should not exert themselves too much on this day. Affected persons and donors should consume sufficient food and fluids. Also to compensate for the loss of fluids. It is also advisable not to take part in road traffic again for about 30 minutes.
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