What is plasmapheresis?

Updated: Mar 08, 2021
  • Author: Elliot Stieglitz, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Plasmapheresis is a term used to refer to a broad range of procedures in which extracorporeal separation of blood components results in a filtered plasma product. [1, 2]

The filtering of plasma from whole blood can be accomplished via centrifugation or the use of semipermeable membranes. [3] Centrifugation takes advantage of the different specific gravities inherent to various blood products, such as red blood cells (RBCs), white blood cells (WBCs), platelets, and plasma. [4] Membrane plasma separation uses differences in particle size to filter plasma from the cellular components of blood. [3]

Traditionally, in the United States, most plasmapheresis is done with automated centrifuge-based technology. [5] In certain instances—in particular, in patients already undergoing hemodialysis—plasmapheresis can be carried out using semipermeable membranes to filter plasma. [4]

In therapeutic plasma exchange, using an automated centrifuge, filtered plasma is discarded and RBCs along with replacement colloid (eg, donor plasma or albumin) are returned to the patient.

In membrane plasma filtration, secondary membrane plasma fractionation can selectively remove undesired macromolecules, which then allows return of the processed plasma to the patient instead of donor plasma or albumin. Examples of secondary membrane plasma fractionation include cascade filtration, [6] thermofiltration, cryofiltration, [7] and low-density lipoprotein pheresis.


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