Plasmapheresis Treatment

What is plasmapheresis?

Plasmapheresis (plasma separation) describes
the process of blood plasma separation, specifically the extraction of the plasma during the donation manually (deprecated) or automatically with Plasmapheresegeraten (preparative plasmapheresis) or
the exchange of blood plasma as a therapeutic measure.

Preparative plasmapheresis

Here, the blood plasma is separated by means of a plasmapheresis device by centrifugation with or without filtration of the blood cells. This separation process is a special form of apheresis. While the blood cells to the donor flow back, the plasma is collected separately and after completion of the donation as soon as possible and within a maximum one hour, frozen and processed to plasma with direct therapeutic application, or passed as plasma for fractionation as a source of plasma derivatives in the industry , The donation process takes about 30 to 70 minutes. The advantage of pure plasma donation to a whole blood donation, with subsequent separation is that the donor loses only a few of the important red blood cells. The resulting fluid loss is quickly compensated by inflowing water from the cell tissue, whereby the donor is hardly affected. In contrast to blood cells, the proteins of the plasma as coagulation factors and albumin are fully compensated and replaced within two days to a week, which the donor is quickly able to donate again. In whole blood donations at least six weeks recovery up to the next donation would be necessary.

The frozen blood plasma is further processed and processed to fresh plasma concentrates (FFP GFP), which are used as frozen or lyophilized preparations for the treatment of coagulation disorders, plasma exchange and massive transfusion. However, it is used in its major amount by plasma fractionation for the preparation of human albumin solutions, coagulation factors and immunoglobulins (plasma-derived).

Therapeutic plasmapheresis

The therapeutic plasmapheresis describes an exchange treatment, in which by means of a Plasmapheresegerätes centrifuged the patient's own plasma and is filtered off, the same time replaced by a substitution solution containing electrolytes, buffering agents (usually hydrogen) and containing from about five percent albumin, or fresh frozen plasma concentrates. This recipe simulates the body's own plasma. Use is this form of treatment that is performed as a rule of nephrologists in autoimmune diseases, which require rapid elimination of the antibodies, otherwise severe organ damage or death are inevitable in life-threatening poisoning, where the toxin has a high protein binding, as well as a pathological increase of plasma proteins with subsequent increase in viscosity with manifestations of central nervous symptoms. Was in the first years after the creation of the technical possibilities for therapeutic plasmapheresis the indication wide, and demonstrated meaningful use areas with more experience are now very limited: Goodpasture syndrome and occur in the context of Plasmozytomerkrankungen hyperviscosity syndrome treated with plasmapheresis, its use in Sudden hearing loss is currently (2006) in the discussion. Furthermore, the plasmapheresis plays an important role in the treatment of relapsing-remitting multiple sclerosis, if the treatment fails with glucocorticoids. Established is the use of plasmapheresis and Guillain-Barré syndrome, thrombotic thrombocytopenic purpura, as well as in chronic inflammatory demyelinating polyneuropathy (CIDP).

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