Some Facts About Plasma Exchange Therapy

By Kathleen Brooks


For a long time, patients with certain blood condition have continued to suffer with very little available to sooth their pain. With new discoveries in the medical field, these patients are now able to manage their lives while grappling with their conditions. Among the advances that have come in handy is plasma exchange therapy (plasmapheresis). In this treatment modality, human blood is transferred to an external machine responsible for centrifugation and cleansing after which the modified form is taken back to the body.

One does not need to spend days in hospital for this procedure to be performed. In fact, no anesthesia is administered due to the simplicity of the process. However, some pain may be experienced in given situations particularly when access to veins is difficult either when they are too small or when they have collapsed because of dehydration. This is why the patient is advised to consume fluids in plenty. Central venous line insertion is the second option when peripheral venous access proves futile.

The relapsing type of multiple sclerosis is a typical example in which plasma exchange is utilized. However, the therapy only comes in handy when first line treatment options have failed. Other conditions that benefit from plasmapheresis include thrombocytopenic purpura, myasthenia gravis and hemolytic uremic syndrome. The essence of the procedure is to eliminate toxic molecules in plasma that are major contributors to pathogenesis of the conditions.

Any medical procedure comes with a risk however small. For plasmapheresis, an allergic reaction by the body to the new product may occur especially for patients who report a history of the same. Premedication to prevent the allergy should be administered in preparation for the actual exchange. Observing sterility should be paramount to avoid the challenge of having to get rid of a hospital acquired infection.

Another typical complication is the formation of clots once the blood leaves the body. This does not routinely occur because of the strict measures put in place. Sodium citrate, given as an infusion, binds calcium, the element needed for clots to form. Unfortunately, this puts the patient at risk of hypocalcemia (low levels of calcium in blood).

Functionality of key systems in the body may be put at risk if hypocalcemia is not reversed in a timely manner. It can present with numbness, tingling and convulsions. Worse cases may present with respiratory distress (due to spasms in the respiratory tract) and difficulty in swallowing (due to uncontrolled muscle contractions). Management is by infusion of fluids containing calcium.

An average of three hours is needed for a single session. Only two or three session are required in one week. At least two weeks are needed for one to complete a cycle of plasmapheresis. The patient is expected to be nursed for weeks or even months. A new cycle can resume if and when the illnesses manifests again.

Evidently, plasmapheresis should not be regarded as a lasting solution, rather a complementary form of management The more the sessions, the higher the cost. Other treatments need to be considered before resorting to plasma exchange.




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