What is plasma?
Plasma is the liquid component of our blood that enables the circulation of blood cells: red blood cells, white blood cells, and platelets. It also transports antibodies, vitamins, hormones, and minerals throughout the body.
Plasma consists mainly of water, protein, and salt, and is typically yellow in colour.
What is plasmapheresis?
Plasmapheresis is a technique used to remove a harmful substance from the blood.
During the procedure, the plasma is separated from the blood cells and removed. The blood cells are returned immediately, along with a replacement fluid. This means the patient’s own plasma is (partially) replaced by donor plasma or a substitute solution.
In most cases, the replacement fluid is a solution containing human proteins. For certain conditions, fresh (frozen) donor plasma is required.
When is plasmapheresis needed?
Plasmapheresis can be used in the treatment of various diseases and conditions.
In some illnesses, harmful substances circulate in the plasma and attack the nerves, which may cause weakened muscle function.
In other disorders, there is an overproduction of certain proteins, making the blood more viscous than normal. This can lead to symptoms such as headaches, blurred vision, or dizziness.
By removing the patient’s own plasma (and the dissolved substances it contains), the concentration of those substances can be reduced enough to positively influence the course of the illness.
Plasmapheresis cannot eliminate the cause of a disease and is therefore usually not the only treatment a patient receives.
How does plasmapheresis take place?
The procedure is carried out using a cell separator, in which a centrifuge separates the different components of the blood.
- A vein is punctured in the crease of one arm. An infusion needle is inserted at this site for the blood collection. During the procedure, you may not bend this arm.
- An infusion needle is also inserted into your other arm for the return of the blood. You can usually move this arm.
- During the blood collection, an anticoagulant is used to prevent the blood from clotting in the tubes. The blood and anticoagulant flow into the centrifuge.
- In the centrifuge, the plasma is separated from the other blood cells and directed into a collection bag. The other blood cells are returned to you along with the replacement fluid via the return infusion.
In this way, approximately one total plasma volume is replaced.
If your veins are too narrow and blood cannot flow sufficiently through the infusion, the anaesthetist will place a central venous catheter, which will remain in place for the entire duration of the treatment. This is done under local anaesthetic in the operating theatre.
Tip
Preferably wear comfortable and practical clothing with short sleeves.
What might you experience during plasmapheresis?
- During the procedure, a small amount of blood is in the tubing of the cell separator. This may cause some people to feel slightly dizzy or light-headed. Always inform a nurse immediately if you start to feel unwell.
- A small amount of the anticoagulant enters your bloodstream, which may cause tingling around the mouth or pins-and-needles sensations in the hands or feet. Please tell a nurse immediately if you notice any of these symptoms.
- You might feel cold, as the blood cools slightly while circulating through the machine. Don’t hesitate to ask the nurse for a blanket.
- If donor plasma is used as the replacement fluid, you may have an allergic reaction to it (e.g. itching, redness, shortness of breath, sweating, etc.).
Frequently asked questions
No, you don’t need to be fasting. On the contrary, it’s better to eat something before the plasmapheresis. We also recommend drinking plenty of fluids in the days leading up to the procedure.
You may also eat and drink during the plasmapheresis. Use the arm that you’re still allowed to bend for this.
It’s a good idea to go to the toilet just before the procedure starts.
The procedure takes 2 to 2.5 hours.
It is best not to take any medication from 2 hours before the start of the procedure.
Always consult your treating doctor in advance to determine which medication can or should be postponed. Some medicines are removed by plasmapheresis or may interfere with the smooth progress of the procedure (e.g. blood thinners, blood pressure medication, etc.).
Apart from inserting the infusion needles, the procedure is painless. The arm used for the blood collection will remain stretched and may not be bent during the procedure. This can be uncomfortable.
Most people experience no side effects during or after the procedure. However, you may feel slightly more tired afterwards. For this reason, especially the first time, we recommend not driving yourself home and arranging for someone to accompany you.
You’ll have a personal television screen available in the day hospital. You’re also welcome to use your own laptop, smartphone, or tablet (the hospital offers free Wi-Fi), read a book or magazine, or listen to music.
If you want to watch or listen to something, please bring your own headphones or earphones. Note: Bluetooth is not supported – you’ll need a wired set with a jack plug.
Yes, you may bring someone to keep you company during plasmapheresis. A nurse is always present in the apheresis room as well.
The number and frequency of plasmapheresis sessions depend on your condition and any symptoms you may have. Your treating doctor will discuss this further with you.