Plasmapheresis

Plasmapheresis aka plasma exchange is a specialised medical procedure that is performed in the ICU for certain patients who are very sick with some specific kidney diseases.

Procedure Overview:

In this procedure, large quantities of plasma are separated from the blood cells of a patient and replaced with fresh frozen plasma, albumin, or saline. The antibodies, if not removed, can damage the kidneys or cause rejection after a kidney transplant.

Plasmapheresis is performed using a special form of dialyzer that filters the blood similar to Haemodialysis procedure along with a blood pump and bloodlines. Here, however, the plasma is exchanged. Replacement fluid is infused into the bloodline. Vascular access in the form of an internal jugular catheter/femoral vein catheter/AV fistula/AV graft is required. A plasma filter is used for the procedure. Anticoagulation is used appropriately.

The procedure is safe and effective, but it may require multiple sessions and medications to prevent the formation of new antibodies.

Conditions Treated with Plasmapheresis:

Some of the conditions requiring plasmapheresis are:

Anti-GBM disease (Anti-glomerular basement membrane diseases)
Hemolytic Uraemic Syndrome/Thrombotic Thrombocytopenic Purpura
Cryoglobulinemia
Some vasculitis processes
Recurrent focal segmental glomerulosclerosis (FSGS) in renal transplant
Sensitised patients waiting for kidney transplant
Antibodies-mediated rejections in kidney transplants

Benefits of plasmapheresis:

Relieves symptoms of autoimmune disorders This procedure helps in relieving symptoms of disorders such as Guillain-Barre syndrome, myasthenia gravis etc.
Removes harmful substances from the blood plasma exchange can help remove harmful substances from the blood.
Use in organ transplants Plasma exchange is useful in reducing antibody levels in sensitized patients awaiting organ transplants to prevent early rejection. And it also helps in removing antibodies in post-organ transplant patients experiencing rejection due to high antibody levels.
Rapidly progressive renal failure Plasma exchange is a useful treatment in some forms of rapidly progressive renal failure due to autoimmune causes.

Potential Risks and Side Effects

As with any medical procedure, plasmapheresis carries some risks and side effects. These include:

Infection Most procedures involving the transfer of blood into or out of the body carry a risk of infection.
Blood clotting Your doctor may prescribe an anti-coagulant to help reduce your risk for blood clots. Plasma exchange also removes clotting proteins and may increase risk of bleeding.
Allergic reaction This is typically a reaction to the solutions used to replace plasma.
Electrolyte imbalance The patient sometimes shows signs of electrolyte imbalance.
Drop in blood pressure during the procedure.

It is vital to know that the risks can be controlled. If you are keen on learning more about it, head over to our blog.

If you are considering plasmapheresis for kidney treatment or any other conditions, you can consult the below doctors to discuss your condition with them. Our doctors are available in Bangalore or at other branches of NU hospitals.