What equipment is needed for plasmapheresis?

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

Plasmapheresis can be accomplished through centrifuge-based platforms such the Cobe Spectra, Fenwal Aurora, and the Fresenius COM.TEC series of devices. Patients require either a double-lumen central venous catheter or two large-bore antecubital peripheral lines.

Plasmapheresis can be performed using a semipermeable membrane-based device in combination with hemodialysis equipment. Central lines, as opposed to peripheral lines, are required for membrane-based plasmapheresis because of their higher flow rates of roughly 100-150 mL/min, as compared with 50-70 mL/min for centrifuge-based equipment.

Two types of membrane-based plasmapheresis technologies exist: hollow fiber and parallel plate. Hollow-fiber dialyzers consist of a bundle of capillaries potted (glued) at both ends into a plastic cylindrical shell. Parallel-plate dialyzers contain layers of stacked membranes with ridges and grooves. Both technologies allow for the separation of plasma from the cellular components of blood based on particle size as well as pressure gradients.

The major advantage of hollow-fiber dialyzers is that they are considered more gentle than parallel-plate technology and are therefore more commonly used in pediatrics. Parallel-plate dialyzers, on the other hand, require less blood volume and therefore less anticoagulant, thereby minimizing the side effects associated with citrate or heparin. Asahi Plasma-Flo is an example of hollow-fiber technology, and Cobe TPE is an example of parallel-plate technology.

An advantage of membrane-based plasmapheresis is that multiple cycles of filtration and ultrafiltration can take place, potentially allowing for the return of beneficial plasma elements while discarding the pathogenic components. [5]


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