Plasmapheresis
Plasmapheresis, or plasma exchange, is a medical procedure designed to remove and replace plasma in the blood, often used for treating specific kidney diseases and other conditions. Here’s a detailed look at its key aspects:
Procedure Overview:
- Objective:
- The main goal is to remove harmful substances, such as antibodies, from the plasma that can damage organs or interfere with treatment.
- How It Works:
- Blood is drawn from the patient and passed through a special dialyzer, which separates the plasma from the blood cells.
- The plasma is then discarded or treated, and replaced with fresh frozen plasma, albumin, or saline.
- Blood cells are returned to the patient along with the replacement fluid.
- Equipment Used:
- Dialyzer: A specialized filter that separates plasma from blood cells.
- Blood Pump: Moves the blood through the system.
- Vascular Access: Typically involves an internal jugular catheter, femoral vein catheter, AV fistula, or AV graft.
- Anticoagulation: Medications used to prevent clotting during the procedure.
- Setting:
- Usually performed in an Intensive Care Unit (ICU) or specialized dialysis center due to its complexity and need for continuous monitoring.
Conditions Treated with Plasmapheresis:
- Anti-GBM Disease:
- A condition where the body’s immune system attacks the glomerular basement membrane in the kidneys.
- Hemolytic Uremic Syndrome (HUS) / Thrombotic Thrombocytopenic Purpura (TTP):
- Conditions characterized by blood clot formation in small blood vessels, leading to kidney failure and other complications.
- Cryoglobulinemia:
- Presence of abnormal proteins in the blood that can cause kidney damage and other issues.
- Vasculitis:
- Inflammation of blood vessels, which can affect multiple organs including the kidneys.
- Recurrent Focal Segmental Glomerulosclerosis (FSGS):
- A form of kidney disease that can recur in kidney transplant recipients.
- Sensitised Patients Awaiting Kidney Transplant:
- Patients with high antibody levels that may cause rejection of a new kidney.
- Antibody-Mediated Rejections:
- Post-transplant rejection caused by antibodies attacking the transplanted organ.
Benefits:
- Relieves Symptoms of Autoimmune Disorders:
- Conditions like Guillain-Barre syndrome and myasthenia gravis can see symptom relief.
- Removes Harmful Substances:
- Helps in eliminating substances that could be harmful to the body.
- Organ Transplants:
- Reduces antibody levels in sensitized patients, preventing rejection of transplanted organs and treating antibody-mediated rejection.
- Rapidly Progressive Renal Failure:
- Effective in treating some forms of acute kidney failure due to autoimmune causes.
Potential Risks and Side Effects:
- Infection:
- Risk associated with the insertion of catheters and the transfer of blood.
- Blood Clotting:
- Risk of bleeding due to removal of clotting proteins; anticoagulants are used to manage this.
- Allergic Reactions:
- Possible reaction to replacement fluids or medications.
- Electrolyte Imbalance:
- Imbalance of minerals in the blood due to fluid replacement.
- Drop in Blood Pressure:
- Can occur during the procedure due to fluid shifts and volume changes.
Consultation:
If you are considering plasmapheresis for treatment, it’s essential to discuss your condition and treatment options with a healthcare professional. They can provide personalized advice based on your specific health needs and the potential benefits and risks of the procedure.