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 Plasmapheresegeräten ( preparative plasmapheresis ) or
• The plasma exchange as a therapeutic measure.

Preparative plasmapheresis

Here, the blood plasma is separated by means of a Plasmapheresegeräts 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 of an hour, frozen and processed to plasma with direct therapeutic application, or passed as plasma for fractionation as starting material for plasma-derived products to the industry. The donation process takes about 30 to 70 minutes. The advantage of pure plasma donation towards a whole blood donation, with subsequent separation is that the donor loses only a few of the important red blood cells. The resulting loss of fluid is rapidly compensated by flowing in the cell water from the tissue, whereby the donor is hardly loaded. In contrast to blood cells, the proteins of the plasma, such as clotting factors and albumin are fully compensated and replaced within two days to a week, so the donor is very quickly able to donate again. In whole blood donations at least six weeks recovery until 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 bulk 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 patients own plasma and is filtered off, the same time replaced by a substitution fluid, electrolytes, buffering agents (usually hydrogen ) and containing from about five percent albumin, or fresh frozen plasma concentrates. This formulation simulates the body's own plasma. Use is that form of treatment which is carried out usually by nephrologists, in autoimmune diseases, which require a rapid elimination of the antibody, since otherwise serious organ damage and death are unavoidable in life-threatening intoxication in which the toxin has a high protein binding, as well as a pathological increase of plasma proteins with resulting increase in viscosity with the occurrence of central nervous symptoms. Was in the first years after the creation of the technical possibilities for therapeutic plasmapheresis the indication wide so demonstrably meaningful use areas with increasing experience nowadays are very limited: Goodpasture syndrome and occurs in the context of Plasmozytomerkrankungen hyperviscosity syndrome treated with plasmapheresis, the use in Sudden hearing loss is currently (2006) in the discussion. Furthermore, 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 the Guillain- Barré syndrome, thrombotic thrombocytopenic purpura, and chronic inflammatory demyelinating polyneuropathy in ( CIDP ).