Blood plasmapheresis indications and contraindications. Membrane plasmapheresis. Pros and cons of plasmapheresis

Plasmapheresis– a procedure that is aimed at cleansing the blood of various substances. It is classified as an extracorporeal hemocorrection method, that is, one in which blood is removed from the body, purified, and then returned back to the vessels. During plasmapheresis, blood is divided into plasma (liquid part) and formed elements (blood cells: red blood cells, white blood cells, platelets). The plasma is removed, and the formed elements are diluted with special blood substitutes and returned back.

It can be considered that the first type of plasmapheresis was bloodletting, which was practiced by the ancient Greeks, and then by doctors in European countries. This procedure was also intended to remove toxins along with the blood. At the same time, before the advent of special technologies, the body lost not only plasma, but also all the cells circulating in it.

Features of the structure and importance of blood in the body

Blood is often called the internal environment of the body. It washes all organs and tissues and comes into contact with almost every cell of the body.

The composition of blood includes a liquid part - plasma - and formed elements, or blood cells: erythrocytes, leukocytes, platelets. Various substances are dissolved in plasma: proteins, antibodies, fats, sugars, hormones, enzymes, substances involved in coagulation.

Basic functions of blood in the body:

• Transfer of oxygen from the lungs to all cells of the body and reverse transport of carbon dioxide (providing respiration).
• Transport of nutrients absorbed from food in the intestines.
• Transport of enzymes and hormones.
• Maintaining constant balance in the body - homeostasis. Blood has constant indicators of acidity and osmotic pressure.
• Providing immune protection: blood cells secrete antibodies and biologically active substances that provide protection against foreign agents.
• Excretion of toxic substances and metabolic products through the kidneys.
• Delivery of toxic substances to the liver for their neutralization.

Thus, blood seems to connect the entire body into a single whole. It reacts to pathological processes that occur in any organ. At the same time, substances that circulate in the blood affect the entire body.

Various substances can be found in the blood in two forms:

• inside or on the surface of blood cells: For example, oxygen and carbon dioxide carried by the bloodstream are bound to hemoglobin in red blood cells;
• dissolved in plasma: This is how the transport of most substances occurs.

Normally, toxic substances and metabolic products are removed from the bloodstream by the liver and kidneys. But with various diseases and pathological conditions, these organs cease to cope with their functions normally. In such cases, plasmapheresis is used.

In what areas of medicine is plasmapheresis used?

Depending on the purpose, there are two types of plasmapheresis:

• Donor– carried out at blood transfusion stations. The donor's plasma, containing beneficial substances, is then transfused into recipients. It can be stored for a long time in frozen and canned form.
• Therapeutic– used to cleanse the blood for various diseases.

Areas of application of therapeutic plasmapheresis:

• Cardiology: chronic diseases of the heart and blood vessels.
• Neurology: chronic diseases of the nervous system.
• Gynecology: chronic diseases of the female reproductive system.
• Endocrinology: dysfunction of the endocrine glands.
• Pulmonology: chronic respiratory diseases.
• Nephrology: chronic diseases of the kidneys and urinary organs.
• Narcology: intoxication of the body with alcohol, drugs.

Types of plasmapheresis

There are various methods by which blood can be separated into liquid and cellular parts. Each of them has its own advantages and disadvantages.

Equipment-free plasmapheresis

These are the simplest methods of blood purification, which do not use special equipment. Today they are used relatively rarely, as an alternative to more complex hardware methods.

Methods of non-hardware plasmapheresis:

• Gravity plasmapheresis. As the name suggests, blood separation occurs under the influence of gravity. Blood from the patient's vein flows through a tube into a plastic bag, where the cells gradually settle and the plasma remains on the surface. This method is the simplest and cheapest. But it allows you to purify small volumes of blood, assumes the great importance of the human factor and the risk of infection.
• Equipment-free filtration plasmapheresis. It is a type of gravitational plasmapheresis. In this case, the blood cells also sink to the bottom of the plastic container, but on their way there is a special membrane that allows only liquid and molecules dissolved in it to pass through. This method, like conventional gravitational plasmapheresis, is simple and inexpensive, but allows for the processing of larger volumes of blood.

Hardware plasmapheresis

These plasmapheresis techniques require the use of special equipment.

Centrifugal plasmapheresis

In this technique, the patient's blood is placed in a centrifuge that rotates at high speed. As a result of the fact that the liquid part and blood cells acquire different accelerations, they are separated from each other.

There are two types of centrifugal plasmapheresis:

• Manual. First, the patient's blood is collected in a special sterile plastic bag. It is then placed in a centrifuge.


• Auto. The patient's blood immediately flows through a tube into a centrifuge, where it is separated into the liquid part and cells. The latter are immediately mixed with blood substitutes and returned to the patient’s vessels. The advantages of this method are: a large number of settings and minimizing the human factor. But to carry out automatic centrifugal plasmapheresis, special equipment is needed.

Filtration (membrane) hardware plasmapheresis

In this case, the patient's blood is passed through a membrane, but this is done using special devices that use a pump that makes pendulum-like movements.

Devices for membrane plasmapheresis make it possible to purify a large volume of blood. This ensures high quality cleaning. Otherwise, the method has the same advantages as automatic centrifugal plasmapheresis.

Cascade plasmapheresis

Cascade plasmapheresis is a type of filtration plasmapheresis in which blood is passed through membranes twice. The first membrane retains cells circulating in the blood, but allows all molecules to pass through. The second retains large molecules, but allows small ones to pass through. This may be necessary for some diseases.

Main indications for cascade plasmapheresis:

• Severe atherosclerosis, in which there is damage to the heart and large vessels.
• Severe autoimmune diseases.
• Severe blood diseases: macroglobulinemia (a disease in which an abnormal protein is formed, which increases blood viscosity and leads to some other disorders), paraproteinemia (a disorder of the protein composition of the blood), thrombocytopenic purpura (a disease in which blood clotting is impaired), myeloma (a type of blood cancer).
• Hemolytic-uremic syndrome: a disease in which anemia develops as a result of massive death of red blood cells, blood clotting disorders, and impaired renal function.
• Autoimmune diseases: systemic lupus erythematosus, systemic scleroderma, rheumatoid arthritis.
• Chronic autoimmune intestinal diseases: ulcerative nonspecific colitis, Crohn's disease.
• Chronic severe diseases of the nervous system: chronic inflammatory polyneuropathy, Guillain-Barré syndrome, myasthenia gravis, multiple sclerosis.
• Severe chronic skin diseases: epidermal toxic necrolysis, bullous pemphigoid, pemphigus.
• Condition after transplantation to prevent an autoimmune reaction to transplanted organs.

Cryoplasmapheresis

During cryoplasmopheresis, the patient's filtered plasma is frozen at -30⁰C. Then, during the next procedure, it is heated to +4⁰C and centrifuged again.

Once the sediment has been removed, the plasma can be reinfused into the patient. The advantage of this method is that the patient’s body practically does not lose protein. Disadvantage: the technique is quite inaccurate.

How is the plasmapheresis procedure performed?

Plasmapheresis is equivalent to surgery, as are transfusions and other methods of blood purification. An average session can last 1 – 2 hours, depending on the plasmapheresis method and the volume of blood that needs to be purified.

The patient is placed on a special chair or couch. To obtain blood, veins are usually used, which are located under the skin at the elbow. The doctor can insert a needle into one vein (when using non-hardware and manual hardware techniques) or into two, on the right and left arm (when using automatic hardware techniques, when blood is taken through one needle and simultaneously returned through the other).

Usually a special catheter, a flexulum, is installed in a vein. It can be easily glued to the skin with an adhesive plaster and heparin, a drug that suppresses blood clotting, prevents the formation of blood clots and catheter blockage, can be injected into it through a special additional hole.

Sometimes, especially if the patient is in serious condition, the doctor cannot insert a needle and catheter into the cubital vein. In this case, catheterization of the subclavian vein is performed. This is a more complex procedure, it can cause a lot of complications, and yet in some cases it has to be resorted to.

What blood substitutes are used to dilute blood cells after they are filtered from plasma?

Name of solution	Description
Saline	A solution of sodium chloride - ordinary salt, which is normally dissolved in the blood at a concentration of 0.9%. Saline solution has the same osmolarity as biological fluids.
Glucose and potassium chloride solution	Potassium is the main ion that is present inside cells. It ensures the maintenance of normal cell form and function, normalizes the functioning of the heart and nervous tissue. Glucose provides osmotic pressure in the blood and is a source of energy for cells.
Reopoliglyukin	Composition of the Reopoliglucin solution: Dextran is a chain of glucose molecules. Saline. Reopolyglucin reduces blood viscosity and restores normal blood flow in small vessels.
Donor or placental albumin	Albumin is the main protein found in blood. Placental and donor albumin is an effective blood substitute.
Donor plasma	The liquid portion of blood received from a donor. It is mainly used in cases where the patient’s blood lacks substances responsible for coagulation processes.

Indications for the use of plasmapheresis

Groupdiseases	Diseases
Diseases of the heart and blood vessels	heart damage due to allergic and autoimmune diseases; viral damage to the heart muscle (viral myocarditis); complications of heart attack; inflammation of the heart of autoimmune origin; atherosclerosis; systemic vasculitis is a group of diseases in which inflammation occurs in the walls of blood vessels due to autoimmune reactions.
Respiratory diseases	Wegener's granulomatosis is a disease in which the blood vessels of the lungs are damaged; fibrosing alveolitis is a disease in which autoimmune inflammation develops in the lungs and breathing is impaired; hemosiderosis is a disease in which massive breakdown of red blood cells occurs, and the resulting substances circulate in the blood and are deposited in the lungs.
Digestive diseases	nonspecific ulcerative colitis - a disease accompanied by chronic inflammation of the wall of the large intestine with the formation of ulcers; Crohn's disease - chronic autoimmune inflammation of the intestines; Setton's stomatitis is a severe allergic inflammation of the oral mucosa.
Liver diseases	chronic autoimmune inflammation of the liver; damage to the brain by toxic substances that are released and found in the bloodstream during liver diseases.
Diseases of the endocrine glands	diabetes mellitus and its complications (vascular damage to the eyes, kidneys, brain, legs); increased sensitivity to insulin; Addison's disease is insufficient function of the adrenal cortex.
Skin diseases	pemphigus; joint damage due to psoriasis; severe allergic reactions: Quincke's edema, urticaria; toxicoderma.
Systemic connective tissue diseases	rheumatoid arthritis; systemic lupus erythematosus; dermatomyositis; systemic scleroderma.
Eye diseases	eye damage due to diseases of the internal secretion organs; inflammation of the choroid (this disease often leads to decreased vision and complete blindness); chronic inflammation of the orbit; damage to the blood vessels of the eyeball in diabetes mellitus.
Allergic diseases	atopic dermatitis - allergic skin lesions; hay fever is an allergic reaction that occurs during a certain season and manifests itself in the form of a runny nose and lacrimation; allergic reactions to various substances; allergic reactions to physical factors: sun rays, heat, cold, etc.
Kidney diseases	glomerulonephritis (inflammation of kidney tissue) of autoimmune origin; inflammation of the kidneys with systemic lupus erythematosus; Goodpasture's syndrome is a disease in which small vessels of the kidneys are damaged; severe kidney and ureter infections; severe renal dysfunction.
Nervous system diseases	multiple sclerosis; chronic infectious diseases of the nervous system; allergic inflammation of brain tissue
Poisoning of the body and reactions to various substances	alcoholism, ethyl alcohol poisoning, hangover syndrome; severe poisoning with certain substances at home and at work; reaction to all medications; drug addiction, substance abuse.

In total, there are about 200 diseases for which plasmapheresis is used. It is rarely used separately: as a rule, it is combined with other techniques.

There are absolute (when the procedure cannot be avoided) and relative (when the procedure is not performed in all cases) indications for plasmapheresis. The decision is made by the attending physician.

During plasmapheresis, plasma is removed from the blood.:

• Immune complexes. These are compounds of antibodies with antigens that settle on organ cells, leading to their damage. They are formed by immune cells during autoimmune diseases.
• Erythrocyte breakdown products. With the massive breakdown of red blood cells, which occurs in some diseases, substances are formed that can damage the cells of the brain, lungs, and heart. They should be neutralized by the liver, but in large quantities it ceases to cope with its functions.
• Toxic metabolic products. They are usually excreted by the kidneys in the urine. But with certain diseases, so many of them are formed that it becomes necessary to remove them artificially. In diseases accompanied by impaired renal function, the removal of toxic substances from the body is impaired.
• Toxic substances produced by malignant tumor cells.
• Toxins of bacteria and viruses.
• Toxic substances entering the body from outside. For example, alcohol.
• Cholesterol. Plasmapheresis is widely used for atherosclerosis.

Complications of plasmapheresis

• Allergic reactions. They can develop in response to the introduction into the body of donor plasma and plasma substitutes, preservatives contained in frozen plasma, and drugs that prevent blood clotting. Manifest in the form of skin rash, chills, fever.
• Anaphylactic shock. This is a severe allergic reaction, which is manifested by impaired consciousness, a drop in blood pressure, and disruption of the heart.
• Citrate poisoning– a substance that is used to reduce blood clotting and prevent the formation of blood clots during the procedure. In this case, numbness occurs in different parts of the body, muscle cramps.
• Drop in blood pressure. This can happen when a large amount of blood is taken from a patient for purification.
• Renal dysfunction. Occurs during autoimmune reactions during plasmapheresis, incompatibility of the recipient’s blood with donor plasma.
• Infection in the blood and development of sepsis(“blood poisoning”). This usually occurs when the rules of asepsis are violated.
• HIV infection. Today, disposable instruments are used, so the likelihood of the human immunodeficiency virus entering the blood of a patient is almost zero.
• Bleeding. In case of an overdose of drugs used to reduce blood clotting, hemorrhages may form under the skin or in internal organs. The risks are especially high if the patient has stomach and intestinal ulcers.
• Thrombosis. If anticoagulants are used in insufficient quantities, blood clots form in or near the catheter on the vessel wall. A piece of the blood clot can break off and enter the bloodstream - this is called a thromboembolism. Pulmonary embolism is especially dangerous - when a blood clot enters one of the vessels carrying blood to the lungs and clogs its lumen. This is fraught with serious complications.

Contraindications to plasmapheresis

Absolute contraindications to plasmapheresis(contraindications for which the procedure should not be performed under any circumstances):

• severe brain damage;
• heavy bleeding.

Relative contraindications to plasmapheresis(contraindications that can be ignored):

• Increased bleeding, blood clotting disorder. During plasmapheresis, agents are used to reduce blood clotting so that the catheter placed in the vein does not become clogged with blood clots. This may lead to increased bleeding.
• Ulcers of the stomach and intestines, in which there is a high risk of bleeding. They may bleed heavily after the procedure.
• Low blood pressure. During plasmapheresis, a certain amount of blood is pumped out of the patient for a period of time. This can lead to a deterioration in the condition of the cardiovascular system.
• Cardiac arrhythmias. Decreased blood volume and decreased blood pressure affect heart function. Arrhythmia may intensify and lead to serious disorders that threaten the patient’s life.
• Low plasma protein levels. During plasmapheresis, along with plasma, the body loses proteins that perform many important functions.
• Acute infections. Any infectious process places a certain burden on the heart and blood vessels. Microorganisms or their toxins enter and circulate in the bloodstream.
• Women's periods. Blood loss occurs during menstruation.

What examination is performed before the plasmapheresis procedure?

Study title	Description	How is it carried out?
General blood analysis	A general clinical study that helps evaluate the content of various cells in the blood (erythrocytes, leukocytes, platelets), hemoglobin, and erythrocyte sedimentation rate.	To carry out a general analysis, a small amount of blood is taken from a finger or from a vein.
Coagulogram and blood clotting time analysis	These studies help assess the state of the blood coagulation system, identify increased bleeding or, on the contrary, a tendency to thrombus formation.	For research, blood is taken from a vein. Before the study, the patient should not take medications that affect blood clotting.
RW blood (Wassermann reaction)	The Wasserman test is a standard test that helps identify syphilis. This test is carried out on all adults entering treatment.	Blood for research is taken from a vein.
Blood glucose test	It is performed in patients with diabetes mellitus. Helps detect elevated blood sugar levels.
Study of protein levels in the blood	The study helps to identify changes in the protein composition of the blood. Low protein content may be a contraindication to plasmapheresis.	For the study, blood is taken from a vein on an empty stomach.
Blood pressure measurement	This is done using a tonometer. If your blood pressure is low, your doctor may postpone or cancel the procedure.
Electrocardiography	During the study, the currents that arise in the heart muscle are recorded in the form of a curve on paper. The doctor evaluates the heart rhythm, the condition of the muscles, ventricles and atria.	The electrical impulses of the heart are recorded using a special device, an electrocardiograph, through electrodes attached to the wrists, ankles, and chest.

Is it possible to perform plasmapheresis in pregnant women?

Pregnancy is not a contraindication for plasmapheresis. This procedure is performed in pregnant women for the following indications:

• for preventive purposes during preparation for pregnancy, especially in women who smoke and have occupational hazards;
• prevention and treatment of infections during pregnancy;
• autoimmune conditions, for example, Rh conflict between mother and fetus;
• fetoplacental insufficiency.

Is plasmapheresis effective for allergies?

An allergy is a pathological condition in which the body's immune system reacts too violently to external stimuli. Lymphocytes release large amounts of antibodies into the blood, which begin to combine with antigens, trying to destroy them. During the plasmapheresis procedure, antibodies and immune complexes can be removed from the blood. Therefore, this technique is widely used to treat allergic and autoimmune diseases.

Usually 3 to 5 procedures are sufficient. After this, the effect lasts for 3 to 6 months.

Can plasmapheresis be used in healthy people for prevention and general cleansing of the body?

Plasmapheresis can be used in a healthy person to prevent autoimmune, infectious and other diseases, in case of occupational hazards, to improve health and improve the overall tone of the body.

But it is worth remembering that in medicine plasmapheresis is considered a surgical intervention. That is, in terms of the degree of invasiveness (penetration into the body), it is the same as surgery. Certain complications are possible. Therefore, before enrolling in a course of procedures, be sure to consult with your doctor.

Plasmapheresis of blood is used to rid it of toxins or reduce the number of other components, for example, red blood cells, platelets, and leukocytes. Mechanical filtration can be either therapeutic or donor. In the first case, after purification, the blood is returned back to the patient, in the second, it is frozen for temporary storage.

For therapeutic purposes, plasmapheresis is used when it is necessary to quickly eliminate intoxication, inflammatory processes, normalize metabolism, when it is necessary to maintain a certain blood composition or create one before surgery.

What is this procedure

Answering the question of what is plasmapheresis, it should be noted that it differs significantly from hemosorption, which is also used for blood purification. During plasmapheresis, it is collected and divided into fractions; during the second procedure, treatment is carried out using sorbents.

There are therapeutic and donor plasmapheresis. The first is used to normalize the patient's condition in various acute and chronic conditions.

The collected blood is divided into formed elements (leukocytes, platelets, red blood cells) and plasma, consisting of saline solutions, protein and other compounds.

After cleaning, the missing liquid is poured back into the patient, replacing the damaged “dirty” part. The donor procedure involves the collection and storage of plasma for subsequent administration to people in need.

In general, the task is to normalize the volume of circulating blood components, remove toxins, paracoagulation products, mediators of inflammatory processes, and transport missing coagulation elements and immunoglobulins into the body.

Effect

When completing the course (from 2 to 6 sessions), the patient feels a significant improvement in his condition. This is explained by the fact that when the blood composition is normalized, the organs begin to function better, feeding only on a healthy environment.

In addition, when cleansing the body, a response occurs and protective reactions are mobilized, in other words, immunity increases.

How does the procedure work?

During treatment, it is recommended to undergo at least 3 sessions. At the first stage, only substances circulating in a free state through the bloodstream are eliminated. At the second stage, products from the intercellular fluid become available. And in the third session, all pathogenic substances of the cells are eliminated.

At one time, you can remove a quarter of the total volume of plasma, of the total amount of blood this will be an eighth. The exact amount is determined by the weight and age of the patient.

Stages of implementation

Plasmapheresis can be carried out either through 1 or 2 catheters.

The significant difference is that in the first case, a small dose is first taken, then purified, and then the treated substance is returned. In the second option, the process is continuous; blood is drawn through one catheter, and then immediately reintroduced through a second catheter in the other arm.

1. The collection involves pumping out a certain volume of blood along with all toxins, viruses, bacteria, cholesterol and formed elements. In this case, the patient is conscious, in a lying or semi-sitting position. The catheter is inserted into the cubital vein.
2. The blood is divided into fractions as it passes through the device.
3. The plasma is completely pumped out, and the remaining suspension is saturated with saline, glucose, potassium chloride, albumin, and rheopolyglucin.
4. The resulting mixture is delivered back to the patient's body.

Types and classification

According to the method of implementation, hardware and discrete types are distinguished. There are therapeutic and donor types according to purpose.

According to the treatment method, plasmapheresis can be:

• Centrifugal or gravity. The Hemofenix device separates the blood into fractions at a high speed of rotation of the drum. Since this method severely damages cells, it is used very rarely.
• Membrane or plasma filtration. It has virtually no contraindications and takes a minimum of time; the cells are not damaged during the cleaning process. A device with pore filters is used.
• Sedimentation or settling method. It is one of the cheapest and is rarely used. In this case, the blood is not subjected to hardware processing, but is only left to settle for a certain amount of time. This method does not allow cleaning large volumes, so the range of applications is small.
• Cascade plasmapheresis. Indicated for severe conditions of autoimmune patients, and is also used in surgery and resuscitation. The main difference is the double cleaning method. First, the cell part is filtered, then the plasma. The disadvantage is the high cost of manipulation.
• Cryoplasmapheresis. The collected blood is frozen at low temperatures, and then heated and centrifuged. The settled part is not used. Area of ​​application - elimination of the consequences of severe poisoning and, as a consequence, intoxication.

Indications

Plasmapheresis is used to remove substances that provoke a pathological process from the body.

Treatment is prescribed for:

• The need to urgently rid the plasma of toxins and metabolic elements caused by autoimmune diseases or inflammatory processes. For example, with rheumatoid arthritis, asthma, sclerosis, hypertension, neuropathy.
• The need to maintain a certain blood composition for a long time. In this case, only one link in the pathogenesis is excluded. Typically, indications for use are Rh-conflict, diabetes, viral hepatitis, in the process of treating oncological pathologies, poisoning with poisons, toxins of bacterial origin.
• Preparation for surgery if the primary composition is unacceptable for surgical intervention.

In general, mechanical blood purification can be used in complex therapy for:

• Multiple myeloma.
• Extensive destruction of red cells in blood vessels.
• The presence of free myoglobin in the blood.
• Hemoglobinopathies.
• Myasthenia.
• Gasser's disease, Crohn's.
• Porphyria.
• Intoxication with chemical poisons.
• Rheumatism.
• Viral myocarditis.
• Asthma, chronic pneumonia.
• Ulcerative colitis.
• Endocrine pathologies, in particular diabetes.
• Peritonitis, sepsis.
• Significant burns.
• Organ rejection after transplantation.
• Herpes, psoriasis.
• Glomerulonephritis.
• Allergic encephalitis.
• Vasculitis.

Contraindications

In some cases, even a useful procedure can lead to a deterioration in the patient’s well-being, so it is not recommended for:

• Anemia when hemoglobin is less than 80 g/l. If you resort to manipulation in this case, oxygen starvation will increase.
• Bleeding of any nature.
• Conditions when the body does not have enough blood. Typically, this list includes pathologies of the cardiovascular system, as well as ulcers and the post-infarction interval.
• Reduced amount of protein in the blood (less than 60 g/l). This indicator is responsible for the permeability of the walls of blood vessels and the level of the liquid component of blood inside them. If the value deviates from the norm, the procedure disrupts the water-electrolyte balance and increases blood pressure.
• Death of cerebral vessels due to circulatory disorders.
• High blood pressure.
• Liver dysfunction.
• Heart diseases.

All contraindications can be:

1. Absolute when there is significant damage to the brain, heart, liver, lungs, kidneys or severe bleeding.
2. Relative. These include blood diseases, when the risk of extensive bleeding is increased, and conditions that provoke bleeding. For example, ulcers, hypotension, pregnancy, menstruation, infectious diseases.

It is also better to refuse manipulation if you are allergic or if negative reactions to blood transfusions have previously been observed.

Benefits and harms of the procedure

Plasmapheresis is rarely performed as the only means of treating a patient; it is usually an auxiliary measure, which explains its success.

The advantages of choosing a method include:

• Detoxification. Getting rid of toxins occurs by “washing” blood cells. In fact, differential assessment helps to separate fractions with harmful substances, and return useful ones back into the bloodstream.
• Stimulation of the hematopoietic and cardiovascular systems on the reflex plane. At the same time, the body is in the recommended water and electrolyte balance. When the need arises, solutions that replace it can be injected into the bloodstream instead of plasma.
• Immunomodulation. Contact of blood with the structure of plasma filters irritates immune cells, which helps improve their performance. But with autoimmune diseases, this can have the opposite effect, since the action of tissues against one’s own body will increase and this will cause an exacerbation of the disease. Therefore, the treatment of such pathologies requires constant medical supervision.

Harm from the procedure may be completely absent, minimal, or, with certain characteristics of the body, lead to the death of the patient. To minimize side effects, the doctor should fully examine the patient before plasmapheresis and prescribe treatment only for serious indications.

In most cases, everything is limited to headache, nausea and a surge in blood pressure, which is explained by the body’s reaction to extreme conditions and does not pose a serious threat. At the same time, an allergic reaction, including an autoimmune one, may develop from the renal apparatus to the donor plasma.

In addition, blood cleansing involves the removal of both harmful and beneficial components, which can temporarily weaken the immune system. If performed incorrectly and with incompetence of personnel, there is a high risk of infection, blood clots, sepsis, and metabolic disorders.

Possible complications

Even with a favorable picture of the examination before the procedure, during the process the body may react negatively to the manipulations performed.

Most often, patients experience the following complications:

• Hypotension. A sharp decrease in blood pressure can cause oxygen starvation. In severe cases, this results in disability or death.
• Anaphylactic shock. Allergic manifestations include changes in hemodynamics, chills, and autonomic disorders. If not treated promptly, it can lead to death.
• Extensive internal bleeding. That is why, in case of an ulcer or erosive areas on the mucous membranes of the gastrointestinal tract, it is better to refuse the procedure.
• Citrate intoxication, in which the patient can fall into a coma, which ends in death. Fortunately, these are isolated cases.

If you feel unwell, you must interrupt the procedure. If this happens outside the walls of a medical facility, immediately consult a doctor or call an ambulance.

Preparation for the procedure

To reduce the risk of complications from manipulation, special preparation is recommended before performing it.

To do this you need:

• Normalize proper nutrition, stick to a high protein diet, but reduce the intake of phosphorus, potassium, and sodium.
• Get enough sleep and drink plenty of fluids the night before plasmapheresis.
• Stop smoking.
• Get a medical examination.

The therapist examines the patient, measures blood pressure, prescribes a clinical and biochemical blood test, determination of glucose, Wasserman reaction, RW, coagulogram, ECG.

Carrying out during pregnancy

The procedure is useful in preparing for conceiving a baby, especially for women who have smoked a lot before. This method helps remove cigarette poison.

During pregnancy, plasmapheresis may be indicated for severe toxicosis. There will be improvements within a couple of sessions.

In addition, during pregnancy the risk of intrauterine infection, oxygen starvation of the fetus, oligohydramnios and extensive bleeding during childbirth is reduced.

How long does one session and course last?

On average, one session lasts 1.5 hours. Plasmapheresis can be repeated after 3-4 days.

For therapeutic purposes, the time increases, the duration of the procedure reaches 2-3 hours, and the frequency is 4-5 times a week. The course includes 3-6 sessions. The number of procedures is selected individually depending on the severity of the disease and the characteristics of the disease. You can undergo treatment again after six months.

Plasmapheresis device

Devices can be portable or stationary. The first ones are convenient because they can be installed anywhere without disturbing the patient’s peace, even at home if necessary. There are devices that first take a small portion of blood, purify it and return it back.

Such devices pump 100-150 ml of biological fluid per minute. Others contain 2 catheters, so that they can be taken out through one and immediately returned through the other. In this case, the device does not stop the process.

The plasma filter contains centrifuges, membranes, pumps or filters. It all depends on the choice of method.

Price

The price for one session is very different and can range from 2,000 to 60,000 rubles. The cost depends on the chosen treatment method, the reputation of the clinic, the experience and competence of the doctor. The region is also of considerable importance: the closer to the center of the capital, the more expensive.

Thanks to the availability of various methods, each patient can choose the right method, focusing on its price. We should not forget that one procedure is usually not enough; at least three are performed.

Application of the method for disease prevention

Despite the fact that the benefits of this manipulation are significant, plasmapheresis is a serious intervention in the structures of the body.

When it is performed, a significant part of the blood is taken, its structure and formula changes, certain elements are extracted or destroyed. It takes a lot of time to replenish them.

In addition, all organs feel a lack of intercellular fluid when plasma volume is restored. According to most experts, such a load on the hematopoietic system and the body as a whole for the purpose of prevention is not justified.

Efferent therapy methods help restore disturbances in homeostasis. Plasmapheresis is also a type of this group. Its advantage is that you can quickly remove toxins and normalize the desired blood composition.

Despite all the advantages, you should not resort to the procedure for prevention, as this is a considerable stress for the body. To avoid complications, the patient is carefully examined before the procedure, and pressure indicators and the functioning of vital systems are monitored during the process.

"How to fix it?" - you ask. The answer is simple. With the help of one very useful modern technique called “plasmapheresis”, which cleanses the plasma of harmful substances and includes a response in the form of activation of material metabolism.

Let's talk in more detail about the procedure and find out if it has contraindications and undesirable effects, and also read the reviews of women who have undergone blood plasmapheresis.

What is plasmapheresis and what is the essence of the procedure?

Surely you associate the word “plasmapheresis” with something terrible. In fact, there is nothing terrifying about this procedure. Plasmapheresis is performed to cleanse the blood of unnecessary substances. Its essence is simple: blood is extracted from the body, then the process of purification occurs, and finally it returns to the vessels.

During the procedure, the blood is divided into two components - the liquid part (plasma) and blood cells: leukocytes, platelets, erythrocytes. So, the plasma is removed permanently, and the formed elements, that is, cells, are diluted with saline, glucose, and special blood substitutes and returned to the bloodstream.

It is also interesting that blood purification is carried out in various ways - with the help of special equipment and without its use.

The hardware-free method is simpler and more affordable. But this is, perhaps, all the advantages of the procedure. When using a non-apparatus method, there is a possibility of contracting an infection. In addition, only a small amount of blood is purified through the procedure.

The hardware method is carried out using special medical equipment, with the help of which the method of blood separation is determined.

1. Centrifugal plasmapheresis. During this method, the patient's blood immediately enters a special centrifuge. As it rotates, the blood is divided into cells and plasma. The cells are immediately diluted with blood substitutes and returned to the vessels.
2. Membrane or filtration method. The blood passes through filters that allow plasma to pass through and retain formed elements.
3. Double filtration plasmapheresis (cascade). During this method, blood is passed through filters twice.

There is another type of plasmapheresis – cryoplasmpheresis. This method is much more complicated and is carried out according to strict indications. Its essence is as follows: the blood is divided into parts. The plasma is frozen at -30 ͦ C, then passed through a centrifuge and returned to the bloodstream. This procedure allows you to preserve almost all the plasma protein.

Indications

The essence of the procedure is more or less clear. “Who really needs blood purification?” - you ask. Initially, the procedure was intended to purify donor material. Now plasmapheresis is often used in medical practice for the auxiliary treatment of various diseases. Moreover, the creators of the method claim that the blood purification procedure can help even with the most severe pathologies, when other therapeutic measures have failed.

So, in what cases is the plasmapheresis procedure indicated?

Using this technique, autoimmune and allergic diseases are successfully treated. During the procedure, all antibodies and immune complexes are removed from the blood. Therefore, if you often suffer from allergies, and medications bring only a temporary effect, go to the doctor and find out if you can cleanse your blood.

What problems can blood plasmapheresis help cope with?

The procedure helps people with severe alcohol, nicotine and drug addictions. In addition, plasmapheresis is vital in cases of intoxication of the body, severe poisoning (poisons), and drug overdose.

The procedure is also successfully used for furunculosis, psoriasis and allergic dermatitis. Therefore, if this problem has been tormenting you for many years, and drug therapy does not help, then the doctor will definitely prescribe a blood purification procedure, during which all factors that provoke skin diseases will be eliminated.

Please note that the procedure is also carried out as a prevention of thrombosis and heart attack. The thickened part of the plasma is removed during plasmapheresis. As a result, the blood thins and blood circulation improves.

Moreover, the technique is often prescribed to pregnant women in the first and second trimesters with severe toxicosis. The procedure does not have a negative impact on the unborn baby or the health of the mother. Using a blood purification technique will also reduce the chances of infection of the fetus, reduce the likelihood of having a baby with a low birth weight and eliminate oxygen starvation in the womb.

After undergoing several plasmapheresis procedures, you will not only strengthen your immune system, activate metabolic processes, get rid of waste and toxins, skin defects, improve memory, get rid of fatigue, but also look younger!

The fact is that with age, cells and tissues are filled with products of material decay, which ultimately leads to a deterioration in material metabolism and local inflammatory processes. The supply of nutrients to cells and tissues deteriorates, which causes dehydration. Plasmapheresis has an effect not only on the skin, but also on the entire body as a whole, freeing it from decay products of substances that have accumulated over many years!

Advantages and disadvantages

One of the most important advantages of the procedure is the vastness of the area of ​​influence. As you know, blood is one of the most important components of our body. Therefore, its purification has a positive effect on all tissues and organs.

There is no need to think that you can get an infection during plasmapheresis. The likelihood of infection in this case is minimal. After all, during the procedure, disposable medical instruments are used for each patient.

The method of blood purification also eliminates the occurrence of unpleasant sensations, except for slight dizziness. The process takes place in the physiological mode of the heart, so all the characteristics of normal blood flow are preserved.

“What about the shortcomings?” - you ask again. Unfortunately, the blood purification method also has disadvantages. One of the most “fat” is the unconfirmed positive effect on a number of diseases.

It should also be said that plasmapheresis is not a separate treatment method. It is used as an additional method of treating one or another health problem. There is no point in carrying it out to everyone.

Contraindications

In the presence of gastric ulcer, plasmapheresis is not performed. In addition, doctors do not recommend the procedure for women with disorders of the blood coagulation system, as well as for those who do not have veins in their arms.

How is plasmapheresis performed?

The procedure can be classified as surgery, like any other blood transfusion. The session lasts approximately 1 hour. The length of the procedure will depend on the amount of blood that needs to be cleaned and the type of plasmapheresis.

Blood cleansing is carried out in this way: the patient lies on a couch or sits in a chair. A plastic catheter is installed in his vein, through which blood is drawn.

Most modern devices are equipped with catheters for veins in both arms. Through one, blood will be taken, and through the other, it will be returned to the bloodstream.

During the procedure, the doctor is constantly next to the patient. All this time, his condition is being monitored - blood pressure, pulse, heart rate, and blood oxygen saturation are measured.

The devices used for plasmapheresis are portable and stationary. The latter are much more convenient, since they can be transported to the patient’s home and to any place in the hospital. Modern devices collect blood in portions - about 40 ml at a time. Then it is cleansed and returned to the vessels. In 1 hour, about 800 ml of blood is purified, that is, approximately 30% of the total volume.

Some devices provide simultaneous administration of anticoagulants to prevent blood clotting.

What results should I expect and when?

Results should be expected only after complete blood purification. Although, doctors and patients claim that for allergic dermatitis and other skin problems, a positive effect is observed after 1-2 procedures.

After each session, the blood condition improves, and the patient feels cheerful, mood improves, and fatigue evaporates. Wounds quickly heal, pimples, blackheads, and age spots disappear.

When purifying plasma, poisons, toxins, viruses, and diseased cells contained in the blood are removed. As a result, the kidneys, liver, lungs and other organs begin to work as usual.

In addition, excess immune complexes that provoke inflammation are eliminated from the blood. As a result, the immune system is strengthened, and the work of those links that were not working is activated.

How much does plasmapheresis cost?

The price depends on the clinic where the procedure is performed and the method of blood purification.

The cost in Russia ranges from 00 rubles, in Ukraine – 2000 – 2700 UAH.

How many courses are needed for best effect?

The doctor calculates the number of procedures depending on the general condition of the patient, the volume of blood and the complexity of the problem that needs to be excluded. On average, to achieve the best effect, 5 to 7 sessions are required.

Possible complications and consequences

Each organism is individual, so it is impossible to predict its reaction to plasmapheresis. Although complications during the procedure are rare, they should still be mentioned.

1. Allergic reactions to blood substitutes. In isolated cases - anaphylactic shock.
2. Severe drop in blood pressure.
3. Bleeding. Occurs when the dose of drugs that reduce the likelihood of blood clotting is exceeded.
4. Blood infection. Occurs during non-apparatus plasmapheresis.
5. Thrombosis. If drugs intended to reduce blood clotting are used in insufficient quantities.

It is also possible that renal failure may develop during blood purification. It occurs when donor plasma is used instead of a blood substitute.

Reviews and is it worth doing?

Desire alone is not enough to carry out the procedure. Blood cleansing is carried out strictly according to the indications of the treating doctor. No cosmetologist has the right to prescribe such a procedure for you just to get rid of acne or other cosmetic defects!

Feedback about the procedure is mostly positive. I would like to note the statement of one pregnant woman who was diagnosed with phospholipid syndrome. The disease predicted the threat of miscarriage. After plasmapheresis, all parameters returned to normal. Fortunately, the woman carried the baby to term and gave birth to a healthy boy.

Surely you will also be interested in the review of a young girl who, after testing, was found to have an increased degree of blood viscosity? And it was connected with smoking! According to her, the result was excellent. The content of the protein that reveals blood viscosity has finally returned to normal, and overall health, as well as the quality of the skin, has improved. The good news is that this young lady, years later, gave up her bad habit!

But the following review evokes mixed emotions. The girl was recommended to undergo the procedure for allergic dermatitis. The result was positive, but she was not impressed with the plasmapheresis process itself. She almost lost consciousness several times, her hands and feet were very cold. At the end of the session, the poor thing felt as if in a dream, there was a metallic taste in her mouth, and she was very thirsty and hungry. The next day she discovered large bruises on her arms, in the area of ​​the veins. It’s a shame, but she would not recommend plasmapheresis to friends and family, despite the positive result.

These are the mixed reviews. From all of the above, we can conclude: each person’s body is unique, therefore, before performing the “plasmapheresis” procedure, it is necessary to undergo a full examination and find out from your doctor in advance what complications may arise.

Health to you and be beautiful! 🙂

Add a comment Cancel reply

Other Articles

Search

Categories

Recent Entries

© Beautiful

Stay confident 24 hours a day!

Membrane plasmapheresis

What is plasmapheresis?

Scientific and technological progress over the past two centuries has brought not only the benefits of civilization, but also led to a significant deterioration of the environment. This is radiation and chemical pollution, the emergence of electromagnetic fields, this is a shortage of environmentally friendly, natural plant food obtained without the use of various mineral fertilizers and genetic engineering. Animals whose meat is eaten are raised using hormones, antibiotics and other additives that are unsafe for the human body.

Such foreign substances accumulate in the body and, in addition to direct toxic effects, cause metabolic disorders. The immune system and mucous membranes suffer, diseases of the internal organs develop, which subsequently become chronic, and the body simply ages.

In recent decades, plasmapheresis has become widely used in many areas of medicine. Historically, plasmapheresis originates from bloodletting, references to which were already made in ancient Egypt. They are mentioned in the works of Hippocrates and Galen.

• rapid removal of toxic substances contained in the blood
• rapid reduction of pathological cells in the blood
• rapid removal of residual factors and pathological substances

The term plasmapheresis comes from the combination of two concepts: “plasma” and “apheresis”, that is, “removal”. The method of membrane plasmapheresis is based on the separation of blood into fractions using a plasma filter. A plasma filter is a disposable, sterile device consisting of multiple porous track membranes. Pores (holes) in the membrane allow blood plasma to pass through and retain formed elements. Thus, during the passage of blood through the plasma filter, plasma containing harmful and ballast substances is removed, and the formed elements are returned to the vein. The plasmapheresis procedure consists of two phases: blood collection and return with simultaneous separation of plasma. During plasma separation, a special plasma-substituting solution is also administered intravenously.

Of course, plasmapheresis is not an isolated procedure, but can be correctly combined with other medical procedures (ozone therapy, ultraviolet irradiation, ILBI) and medications. The result, of course, depends on the initial state of the body, the volume of plasma removed, the number of procedures and their frequency. The effectiveness of plasmapheresis is expressed in reducing the length of stay of patients in hospital or on outpatient sick leave, reducing the amount of medications consumed, reducing mortality, prolonging the patient’s life and improving its quality.

Membrane plasmapheresis methods are indicated for all pathological conditions that require correction of the composition of plasma, blood cells, as well as immune disorders. Plasmapheresis allows you to remove microbes and toxins, circulating immune complexes, inflammatory mediators, metabolic products, components of destroyed and defective cells, hormones, and other toxic and biologically active substances from the blood. A comparison of the results of clinical, instrumental and laboratory examinations of patients before and after plasmapheresis allows us to draw the following conclusions: plasmapheresis provides immunocorrection, improvement of blood microcirculation, anti-inflammatory, anti-allergenic and antitoxic effects.

Plasmapheresis is used to treat more than 200 diseases, and, most importantly, to prevent their occurrence, improve the health and rejuvenation of the body, stimulate the immune system, increase the duration and improve the quality of life. Indications for the use of membrane plasmapheresis are constantly expanding; the combination of traditional treatment and plasmapheresis is especially effective.

Plasmapheresis is used for:

• prevention of various diseases
• herpetic, cytomegalovirus, papillomavirus infections
• sexually transmitted infections (STIs)
• frequent colds
• allergic diseases (acute and chronic urticaria, atopic dermatitis, hay fever)
• acute and chronic intoxication
• skin diseases (eczema, psoriasis, neurodermatitis)
• furunculosis
• staphylococcal infection
• diseases of the teeth and oral cavity
• atherosclerosis
• increased cholesterol
• increased bilirubin
• cardiac ischemia
• post-infarction conditions
• hypertonic disease
• autoimmune diseases
• chronic inflammatory diseases of the uterus and appendages
• premenstrual syndrome
• sclerocystic ovaries
• infertility
• miscarriage
• toxicosis of pregnant women
• climacteric syndrome
• rheumatoid arthritis
• bronchial asthma
• Chronical bronchitis
• diabetes
• thyroid diseases
• glomerulonephritis
• nervous diseases
• chronic fatigue syndrome
• pancreatitis
• cholecystitis
• hepatitis
• myasthenia gravis
• depression
• gout

Frequently asked questions about plasmapheresis and their answers:

1. What is membrane plasmapheresis?

Plasmapheresis is low-traumatic and highly safe (the possibility of infection with hepatitis and HIV is excluded), the most effective and unique method of blood purification.

Are plasmapheresis and blood purification the same thing?

Yes, plasmapheresis and blood purification are the same thing.

How many plasmapheresis procedures do you need to undergo?

From 2 to 5 procedures.

How long does one procedure take?

The duration of plasmapheresis is approximately 1 hour.

How does a person feel during plasmapheresis?

At the beginning of the procedure - an injection into a vein. The patient then remains in peace and comfort. You can take a nap, read or listen to music.

Is the procedure painful?

The procedure itself is absolutely painless.

What contraindications exist?

Irreversible damage to the brain and other vital organs, uncontrolled bleeding, bleeding disorders.

Are there age restrictions?

In our clinic, plasmapheresis is performed on patients over 15 years of age.

What is the difference between plasmapheresis and ILBI and ultraviolet blood irradiation?

Plasmapheresis is the removal of part of the plasma with the pathogenic cells and substances it contains. ILBI and ultraviolet irradiation are stimulation of blood cells and immunity.

Who performs plasmapheresis?

The procedure is performed by an anesthesiologist who has undergone special training. A nurse is helping him.

How is the plasmapheresis procedure performed?

The procedure takes place in a room specially designed for this purpose. The patient sits comfortably on a functional bed. A vein in one arm is punctured. The collected blood passes through a filter in which contaminated plasma containing toxins, pathological immune complexes, antigens, hormones, inflammatory agents and markers of intoxication is separated from the good blood and removed, and the purified blood is returned to the body.

Is there a danger of infection?

The danger of infection is completely eliminated, since all materials used are disposable.

How much blood can be purified in 1 session?

During one procedure, up to 30% of the blood is purified.

How often can plasmapheresis be performed?

1-2 times a year. For some diseases, the plasmapheresis regimen is developed individually.

Is any preliminary preparation necessary before the procedure?

There is no need for special preparation.

Is it possible to administer any medications at the same time?

According to indications, additional intravenous administration of medications is carried out.

What is the cost of plasmapheresis?

The cost of one plasmapheresis procedure is 3,600 rubles.

Today we will talk about:

Plasmapheresis is the name of the procedure by which blood plasma is purified. This universal method is applicable for diseases of various origins. As a result of plasmapheresis, a certain amount of blood plasma is removed from the body.

Therapeutic effect of the procedure

Blood can be divided into two components: liquid and cellular. The cellular component is represented by the formed elements of blood (erythrocytes, leukocytes and platelets), and the liquid component is represented directly by plasma, which consists of protein and saline solutions; there are also compounds present that are dangerous to the body.

The plasmapheresis procedure has a pronounced therapeutic effect: when part of the plasma is removed, the patient’s body also leaves the harmful substances that caused a particular disease. Such “pests” are considered to be cholesterol, uric acid, pathological proteins, and protein breakdown products. The affected organs and their systems will begin to function better as soon as the quality of the patient’s blood increases. In addition, one more positive side of plasmapheresis can be noted: as a result of mechanical purification of the blood from harmful toxins, the body forms a response - mobilizes its defenses.

Most often, plasmapheresis is included as part of complex therapy, since its use as an independent procedure does not always produce visible results, and the effect does not last long. The method of mechanical blood purification is combined, as a rule, with therapeutic procedures that partially prevent the saturation of the blood with toxins, the formation of dangerous compounds in the body itself, and also stimulate their unhindered elimination from the body.

Methods of carrying out the procedure

At one time, approximately ¼ of the total volume of blood plasma is removed from the human body. All plasma takes up a little more than half of the blood, while the volume of the blood itself depends on how much the patient weighs. Thus, in a patient weighing 70 kg, approximately 700 g of blood plasma will be removed during the plasmapheresis procedure. The number of sessions is determined by the diagnosis and severity of the disease, but generally ranges from 2 – 3 to 12 sessions.

There are several ways to extract plasma from blood:

• Filtration. Using a special filter, cellular and plasma components are isolated from the blood. Next, the cellular part is diluted with a 0.9% sodium chloride solution and returned to the body, the plasma component is removed.
• Gravitational. The patient donates 0.5 liters of blood from a vein into a special container, which is then sent to a centrifuge. The blood cells settle there and are later returned to the patient’s body as part of a saline solution. To achieve a therapeutic effect, it is necessary to conduct at least 3 sessions of gravitational plasmapheresis.
• Plasmasorption. This version of plasmapheresis is not based on the extraction of plasma, but on its purification from the blood. Activated carbon is used as a special sorbent for the cleansing procedure.

If indicated, all methods of mechanical blood purification can be supplemented with a procedure during which blood cells are irradiated with ultraviolet light.

Indications for blood purification through plasmapheresis

The list of pathologies for which plasmapheresis is indicated for a patient is very extensive, and PoMedicine once again reminds us that a lasting positive effect after such a cleansing procedure is observed only in combination with other therapeutic methods. It is advisable to use mechanical blood purification for the following diseases and conditions:

Multiple myeloma;
massive destruction of red blood cells inside the vessels;
free myoglobin in the blood;
hemoglobinopathy;
intoxication with poisons of chemical origin;
porphyria;
myasthenia gravis;
Gasser's disease.

Mechanical blood purification also has a beneficial effect on the patient with the following diseases:

;
viral myocarditis;
chronic pneumonia;
bronchial asthma;
Crohn's disease;
ulcerative colitis;
diabetes;
psoriasis;
herpes;
nettle rash;
endocrine diseases of the organs of vision;
glomerulonephritis;
encephalitis caused by allergies;
atherosclerosis;
systemic vasculitis;
rejection of a transplanted organ;
extensive burns;
acute peritonitis;
sepsis.

Contraindications to the procedure

Unfortunately, even such a seemingly useful procedure as plasmapheresis has side effects. The point is that the blood plasma also leaves the body with substances useful to the body: proteins (including immunoglobulins) and components of the blood coagulation system (prothrombin, fibrinogen). On this basis, blood purification is not carried out if the patient is diagnosed with low levels of protein in the blood, as well as if there is a high probability of bleeding (usually occurs if the liver is severely damaged).

Contraindications to plasmapheresis are divided into absolute and relative.

Absolute contraindications include serious damage to vital organs (brain, heart, lungs, kidneys or liver), massive bleeding.

Relative contraindications include high bleeding and a high risk of bleeding due to various diseases (for example, stomach and duodenal ulcers), lack of stability in the circulatory system (hypotension), low protein concentration in the blood, diseases of infectious origin, pregnancy and menstruation.

We list the absolute contraindications to plasmapheresis:

• Overload of the cardiovascular system (in particular the right side of the heart).
• Pathological death of cerebral vessels due to impaired cerebral circulation.
• Excessive increase in blood pressure.
• Drug addiction and other neuropsychiatric disorders.
• The blood is too thick.
• Acute or chronic liver dysfunction.

A blood purification session in the presence of the listed diseases can result in death for the patient.

The issue of using plasmapheresis to rid a patient of alcohol dependence is controversial. Although this procedure can remove alcohol from the blood, after some time a withdrawal syndrome inevitably develops, expressed by some kind of neuropsychic disorder, disruption of the cardiovascular system, cerebral edema, and liver dysfunction. In a word, using plasmapheresis in the treatment of drug addiction patients is inappropriate and dangerous for the patients’ lives. Alcoholism and drug addiction respond well to xenotherapy.

The essence of this intervention is to remove part of the patient’s blood from the bloodstream, remove toxic and other substances unnecessary for the body, and then return it back to the bloodstream.

There are 2 main types of plasmapheresis – donor and therapeutic. The essence of the first is to collect plasma from a donor and then use it for its intended purpose. The second is carried out to treat a number of different diseases. It is about therapeutic plasmapheresis - its types, indications and contraindications for use, methods of carrying out the procedure, as well as possible adverse reactions and complications that will be discussed in our article.

Why does the body need blood?

Blood is one of the organs of the human and animal body. Yes, this organ is liquid and circulates through special vessels, but its health is no less important for the body than the health of the liver, heart or other structures of our body.

Blood consists of plasma and formed elements (erythrocytes, leukocytes, platelets), each of which performs specific functions. Blood also contains various substances dissolved in it - hormones, enzymes, coagulation factors, proteins, circulating immune complexes, metabolic products and others. Some of them are physiological for the body, while others (for example, cholesterol) lead to the development of diseases.

Plasmapheresis will help rid the blood, and therefore the entire body, of substances dangerous to its health.

Effects of plasmapheresis and types of procedure

Plasmapheresis is not magic, it is not capable of restoring youth to the body and healing it from all diseases, however, the effects that this procedure has alleviate the course of some diseases and undoubtedly improve the patient’s condition.

1. During a plasmapheresis session, part of the plasma is irretrievably removed from the bloodstream. Along with it, various pathogenic substances are also removed, for example, toxins of bacteria, viruses, circulating immune complexes, breakdown products of red blood cells, cholesterol, metabolic products and others.
2. Before blood cells are returned to the bloodstream, they are diluted with saline, glucose and blood substitutes to the required volume. This improves blood flow and reduces the risk of blood clots.
3. As a result of the removal of a certain volume of plasma, many physiological reactions of the body are activated, and its resistance to the effects of adverse environmental factors increases.

As for classification, plasmapheresis is primarily divided into non-hardware and hardware. Hardware-free methods do not involve the use of special devices. They are quite simple and financially accessible to many, but they allow only a small volume of blood to be purified and carry an increased risk of infection and other complications. Hardware plasmapheresis is carried out using special devices. Its leading methods are:

• filtration, or membrane (blood passes through special filters that pass its liquid part - plasma and retaining formed elements);
• centrifugal (the patient’s blood enters a centrifuge, as a result of the rotation of which the blood plasma and its formed elements are separated from each other; the cells are immediately mixed with blood substitute solutions and returned to the bloodstream);
• cascade, or double filtration plasmapheresis (this method involves passing blood through filters 2 times; the first retains cells, and the second - large molecules).

Another type of this procedure is cryoplasmapheresis. The blood is filtered, the separated plasma is frozen at -30 ° C, during the next session it is heated to +4 ° C, centrifuged, and then reintroduced into the patient’s body. This method allows you to preserve almost all of the plasma protein, but it is used only under strict indications.

Indications and contraindications for plasmapheresis

This procedure should not be the initial and only method of treatment. It is used only in combination with medication and other treatment options, and then only when these methods have exhausted themselves and have not led to any positive result.

Indications for plasmapheresis are:

• diseases of the cardiovascular system (viral, autoimmune myocarditis, rheumatic heart disease, systemic vasculitis, atherosclerosis and others);
• pathology of the respiratory system (bronchial asthma, Wegener's granulomatosis, fibrosing alveolitis, hemosiderosis, and so on);
• diseases of the digestive tract (Crohn's disease,
• nonspecific ulcerative colitis, hepatic encephalopathy and others);
• diseases of the endocrine system (diabetes mellitus, adrenal insufficiency);
• urinary tract diseases (autoimmune glomerulonephritis, severe pyelonephritis, cystitis and other infectious diseases, chronic renal failure, Goodpasture's syndrome, secondary kidney damage in systemic connective tissue diseases);
• systemic connective tissue diseases (dermatomyositis, scleroderma, systemic lupus erythematosus, rheumatoid arthritis, psoriatic arthritis and others);
• skin pathology (psoriasis, herpes, pemphigus, toxicoderma);
• diseases of an allergic nature (acute or chronic urticaria, Quincke's edema, hay fever, atopic dermatitis, heat, cold allergies and others);
• diseases of the nervous system (chronic infectious diseases, multiple sclerosis and others);
• eye diseases (diabetic retinopathy and others);
• poisoning by various chemicals at work and at home, including drug overdose;
• hangover syndrome;
• during pregnancy – fetoplacental insufficiency, maternal diseases of an autoimmune nature, Rh conflict.

In some cases, plasmapheresis is categorically not recommended. Absolute contraindications to this procedure are:

• ongoing bleeding;
• severe brain diseases (stroke and others);
• cardiac, hepatic, renal failure in the decompensation phase;
• acute neuropsychiatric disorders.

There are also relative contraindications, that is, those conditions that it is desirable to eliminate (compensate) before plasmapheresis, but in case of urgent need, solely by the decision of a specialist, this procedure can be performed with them. These are:

• disorders in the blood coagulation system;
• hypotension (low blood pressure);
• heart rhythm disturbances;
• ulcerative damage to the digestive tract (stomach, intestines);
• reduced protein content in blood plasma;
• period of menstruation in women.

Plasmapheresis for these conditions is associated with an increased risk of aggravating them - the development of more severe cardiac arrhythmias, lowering blood pressure, bleeding, and so on. In such situations, the doctor must pay increased attention to the patient’s condition and take actions to stabilize it.

Do I need to get examined?

In essence, plasmapheresis is a surgical intervention for which there are both indications and contraindications. In order to detect these conditions, before starting a course of treatment with this method, the patient must undergo an examination. It includes:

• examination by a therapist or other doctor, including measurement of blood pressure and assessment of other important indicators of the body’s functioning;
• clinical blood test (to promptly diagnose acute or chronic inflammatory process or other serious diseases);
• a blood test for glucose (included in the list of mandatory examinations for every patient; it allows diagnosing diabetes mellitus, and in those with a confirmed diagnosis, monitoring blood sugar levels);
• coagulogram (to assess the parameters of the blood coagulation system, detect a tendency to form blood clots or increased bleeding);
• a blood test for the Wasserman reaction, or RW (this is also a mandatory diagnostic method that allows you to detect or exclude such an unpleasant pathology as syphilis);
• biochemical blood test to determine the level of protein fractions in it (allows you to diagnose hypoproteinemia, which is a relative contraindication to plasmapheresis sessions);
• ECG (allows you to evaluate the work of the heart).

At the discretion of the doctor, the patient may be prescribed other examination methods that confirm the need for plasmapheresis or, on the contrary, exclude this method of treatment for a particular patient.

Methodology

Plasmapheresis is one of the options for surgical intervention in the human body. That is why it should be carried out not just anyhow, not during a lunch break, but after a full examination, in specially equipped rooms, in conditions similar to those in the operating room.

During the procedure, the patient is in a lying or reclining position on his back on a regular couch or in a special chair. A needle or a special catheter is inserted into his vein (usually in the elbow area), through which blood is obtained. Most modern devices for plasmapheresis provide for the installation of needles in 2 arms at once - through the first, blood will leave the body and enter the device, and through the second, it will simultaneously return to the bloodstream.

As described above, blood, passing through the apparatus, is divided into fractions in various ways - plasma (liquid part) and formed elements. The plasma is removed, the suspension of blood cells is diluted with saline, solutions of glucose and potassium chloride, rheopolyglucin, albumin or donor plasma (by the way, it is used for this purpose very rarely and according to strict indications) to the required volume and injected back into the patient’s body.

1 session lasts from 1 to 2 hours. This depends on the plasmapheresis method used and the patient’s condition. The amount of blood “driven” through the device in 1 session also varies and is determined individually using the calculation of special computer programs and the specialist who prescribes and carries out the treatment.

The entire time plasmapheresis is performed, the doctor remains next to the patient, carefully monitoring his general condition and well-being, monitoring blood pressure, pulse rate, blood oxygen saturation level and other important parameters of his body. If complications develop, he, of course, provides assistance to the patient.

How many plasmapheresis procedures a particular patient needs is determined individually. The course of treatment depends primarily on the disease that is supposed to be treated with this method, as well as on the individual reaction of the patient’s body to treatment. As a rule, it includes from 3 to 12 sessions.

Complications

With a professional, responsible approach to his work by the specialist performing plasmapheresis, with a complete examination of the patient, and with the use of modern high-quality equipment, the procedures are well tolerated by patients, and unpleasant situations occur extremely rarely. However, since each organism is individual, it is impossible to completely predict its reaction to plasmapheresis - in some cases complications still develop. The main ones are:

• allergic reactions up to anaphylactic shock (as a rule, they develop in response to the introduction of donor plasma or drugs that prevent the formation of blood clots into the bloodstream);
• hypotension (a sharp decrease in blood pressure; occurs in cases when a large volume of blood is simultaneously removed from the patient’s bloodstream);
• bleeding (develops as a result of exceeding the dose of drugs that reduce the ability of blood to clot);
• the formation of blood clots (they are a consequence of an insufficient dose of the above drugs; blood clots spread with the blood flow and, entering vessels of a smaller diameter, clog them; these conditions are extremely dangerous for the patient’s life);
• blood infection (occurs when the rules of asepsis are violated during plasmapheresis, more often with non-hardware methods of this procedure, but with hardware - extremely rarely);
• renal failure (can develop if donor plasma is used as a blood substitute; it is a consequence of the latter’s incompatibility with the blood of a person receiving plasmapheresis).

Conclusion

Plasmapheresis is one of the efferent medicine methods most commonly used today. During the procedure, the patient’s blood is removed from his bloodstream, enters the apparatus, where it is divided into 2 fractions - liquid (plasma) and formed elements. The plasma with the pathological substances it contains is removed, and the blood cells are dissolved with blood substitutes and returned to the bloodstream.

This method of treatment is auxiliary, used only when other methods have proven ineffective, and complements them. Many people believe that plasmapheresis is an almost magical healing technique that will rid the body of problems that have accumulated in it for decades, and can even be used as a preventive method. Unfortunately no. There are certain indications for it, and your doctor is unlikely to recommend it to you if other, non-invasive treatment methods have not yet been tried. Still, plasmapheresis is a surgical intervention that requires certain preparation and can lead to the development of complications.

However, when carried out according to indications, plasmapheresis is very effective and can significantly improve the patient’s condition in just a few sessions.

TVK, experts talk about plasmapheresis:

Plasmapheresis (plasmophoresis): features of the method, indications and contraindications for its use

Plasmapheresis is a blood purification process performed outside the body. It is performed to remove toxic substances that poison the body or to use plasma in the future - donor plasmapheresis.

The concept of the method and its types

Plasmapheresis, as well as plasmaphoresis and plasmaphoresis, is an extracorporeal procedure performed mainly to cleanse the blood of toxic substances. The essence of the procedure is quite simple: the blood extracted from the patient is placed in a hemocontainer, in which it is separated into plasma and formed elements - red blood cells, leukocytes and platelets. Then the blood cells are returned to the body, and the plasma is disposed of or used for other needs - transfusions, the production of blood products, and so on.

To return to the patient a volume of blood equal to that taken, the lack of plasma is replenished with saline or other liquid, if required by the treatment of the disease. In this way, the blood is cleared of all toxins dissolved in the plasma and does not lose its functional cells.

Plasmapheresis is classified according to several criteria.

This video is dedicated to the concept of plasmapheresis:

Classification

By purpose

The procedure is used to solve 2 problems:

• therapeutic plasmapheresis - its purpose is precisely to cleanse the blood of toxic substances. In this case, the plasma is utilized, although it happens that after several additional filtrations the plasma is returned along with the blood;
• donor - in this case, the procedure is carried out with the aim of obtaining pure donor plasma. The blood cells are returned and the plasma is used for transfusions or when receiving certain medications.

Cryophoresis is also distinguished. In this case, the resulting plasma is first frozen and returned after freezing.

By cleaning method

All blood purification methods used are divided into 2 groups: manual and automatic.

• Manual - or discrete. A fairly large amount of blood is collected one-time, which is placed in a sterile hemocontainer and purified. The cells remaining after removal of the plasma are diluted with saline and injected into the patient. The manual method is divided into 2 types:
  • sedimentation - plasma is separated from the cell mass by settling, the latter precipitates;
  • gravitational - or centrifugal. The blood in the container is placed in a centrifuge, where it is separated into elements, since they have different rotation speeds. This method is considered outdated and is used infrequently.
• Hardware – sampling process. Cleaning and blood return occurs continuously. Blood is taken in small portions, fed to a separation apparatus and returned in small portions. This method is much easier to tolerate by patients, as it does not create a burden.

There are several types of hardware plasmapheresis - membrane, cascade, and so on.

According to execution technology

There are 2 methods of blood purification in devices and hardware systems, so all methods are divided into 2 main groups.

• Centrifugation is the most commonly used method. Modern centrifuges are regulated by special programs that allow precise rotation and braking speeds to be maintained. In this way, the blood cells, as well as the protein and carbohydrate structures of the plasma, are preserved. After centrifugation, blood cells with a blood substitute or plasma purified through filters are returned to the patient’s body. Today, such a procedure is carried out much faster and does not put a strain on the human body. Blood purification by centrifugation is actively used in pulmonology for a number of diseases of the upper respiratory tract, in endocrinology for the treatment of diabetes, for example, Addison's disease, and, of course, in dermatology for dermatitis and herpes caused by disturbances in the functioning of the immune system.
• Separation through membrane filters is a painless and completely safe method. The blood enters the hemo-container and passes through a disposable filter. In this case, the plasma is separated along with fragments of cell walls, toxins, allergens, lipoproteins and other things.

A variation of the membrane method is the cascade method. In this case, the blood passes through 2 filters: the first one retains cellular mass, the second one retains large organic molecules. Plasma purified in this way can be reintroduced into the patient’s body. Cascade plasmapheresis is considered more effective in severe autoimmune diseases.

Advantages and disadvantages

Plasmapheresis allows you to rid the body of accumulated or released toxins, including allergens, antigens, inflammatory mediators, and so on. But as a treatment method, plasmapheresis has both its advantages and disadvantages.

• For some diseases, this method is indispensable - in case of acute poisoning, for example, blood poisoning, liver dysfunction, when the blood simply is not cleansed, and so on.
• The procedure improves the composition of the blood and removes not only metabolic products, but also hormones, mediators, antigens, antibodies, and so on. This is one of the best methods to suppress severe allergic reactions.
• The blood becomes less viscous, blood circulation increases, providing nutrition and oxygen to all tissues of the body.
• Side effects are minimal and complications are extremely rare.
• When blood is drawn, fluid from surrounding tissues rushes to the vessels to compensate for the lack of volume. Thus, the procedure also solves the problem of edema of all kinds.

The disadvantages of the procedure are related to the implementation features.

• The cleaning effect is short-lived when it comes to illness. In case of poisoning, 1-2 procedures are enough to remove toxins. But if they continue to arrive, then the effect lasts for about a day, that is, plasmapheresis should be carried out in a course that includes at least 10 procedures.
• The cost of plasmapheresis is considerable. Although it differs noticeably depending on the method of implementation: the price of the gravity method is noticeably lower than the cascade method.
• The procedure has a number of contraindications, since immunoglobulins, fibronogen and other proteins are removed from the blood along with toxins.

Indications for testing

Plasmapheresis is used extremely widely.

• There are no age or gender restrictions: even the youngest patients are prescribed membrane blood purification if the child’s condition requires it.
• In old age, this procedure is often a much more effective remedy in the treatment of ailments, especially skin ones.
• Plasmapheresis is also used during pregnancy, mainly for the prevention of autoimmune diseases, especially the conflict of Rh factors, as well as for fetoplacental insufficiency.

There are absolute and relative indications for the procedure. In the first case, refusal of plasma exchange can lead to death. These appointments include:

Relative indications are:

In dermatology, plasmapheresis is prescribed for:

The procedure allows you to get rid of the main provoking factor - allergen, antibodies, and so on - in the shortest possible time. Of course, 1 session will not fix the problem: the average course for dermatological diseases is 5–7 procedures, although the effect, especially for allergic dermatitis, appears after 2 sessions.

Contraindications to the use of plasmapheresis

Plasmapheresis has a number of contraindications. Some of them should never be violated; in other cases, the potential risks and benefits must be assessed.

Absolute contraindications include:

• bleeding - internal or external. The body cannot bear such a load;
• irreversible changes in the heart and brain;
• severe injuries to internal organs;
• non-coagulability of blood makes the procedure impossible.

• arrhythmia and low blood pressure, as after the session the pressure decreases;
• stomach ulcers;
• anemia, especially in old age;
• acute infectious diseases;
• state of shock.

Preparation for the procedure

Plasmapheresis is not the easiest procedure. It lasts at least an hour and has a number of contraindications, so before such a procedure is prescribed, the patient must undergo an examination. It includes:

• examination by a therapist and a leading doctor of another profile. What is important is the level of blood pressure, the condition of the heart, the presence of peptic ulcers, and so on;
• A blood test for glucose and a Wasserman reaction test are required to exclude syphilis;
• biochemical blood test - allows you to evaluate the level of proteins to exclude hypoproteinemia. During plasmapheresis, a number of proteins are removed along with the plasma, so if their concentration is low, it is better to abandon this method;
• coagulogram - allows you to evaluate blood clotting: tendency to thrombus formation - then the procedure is indicated, or increased bleeding;
• ECG - in case of severe disturbances in the functioning of the heart, plasmapheresis is not permitted.

The actual preparation for the event is very simple. A few days before the session, you need to give up alcohol and coffee and drink more fluids. Before the session, you need to eat a light and balanced meal.

How is the procedure performed?

Plasmapheresis is a fairly lengthy but painless procedure that does not create any inconvenience. The session is held in a specially equipped room.

1. The patient is placed on a couch or chair - a supine or reclining position.
2. A needle or catheter is inserted into a vein, through which blood is drawn. Most often, the fence is taken from a vein in the bend of the elbow.
3. In modern devices, it is necessary to install 2 needles: through the first, blood is drawn, through the second, the blood is returned to the patient’s body.
4. The blood is transferred to a hemocontainer and then divided into fractions. The separation method depends on the type of apparatus used. In this case, the plasma is removed and replaced with saline solution, glucose solution, potassium chloride, donor plasma or other blood substitutes in an appropriate volume.
5. Through the second needle, blood is returned to the patient in exactly the same volume as it was taken. It is possible to administer prescribed medications in parallel with the return of blood.

Session duration is 1–2 hours. The amount of purified blood is determined by the purification method and medical recommendations. The procedure is performed by an anesthesiologist who has undergone special training or a transfusiologist. On average, up to 30% of the blood is purified in 1 session.

During the session, the doctor or nurse is constantly with the patient. Conditions are constantly monitored: blood pressure, heart rate, blood composition, and so on.

Consequences and possible complications

The purpose of the procedure is blood purification. Plasmapheresis allows you to get rid of antibodies, antigens, pathological immune complexes, breakdown products, inflammatory mediators, and so on. In this way, it is possible to quickly get rid of intoxication from the body, restore immunity, and suppress various allergic reactions.

In addition, plasmapheresis improves blood circulation, including peripheral circulation, and also promotes lymphatic drainage, reducing the amount of edema. During pregnancy, plasmapheresis is often prescribed as a preventative measure. This is especially true for women who smoke.

However, the procedure can also have negative consequences:

• when administering drugs that prevent the formation of blood clots, as well as donor plasma, an allergic reaction up to anaphylactic shock is possible;
• hypotension – when a large volume of blood is removed, a sharp drop in pressure is possible. Typically this applies to manual methods;
• bleeding - may occur with the administration of drugs that reduce the ability to clot;
• formation of blood clots - with an insufficient dose of such drugs, blood clots may spread and enter vessels with a smaller diameter;
• infection is possible if the procedure is violated. In hardware methods, such a possibility is practically excluded;
• renal failure is possible if donor plasma is used instead of saline, since there is a risk of incompatibility.

Complications after plasmapheresis are discussed in the video below:

Recovery and care after the procedure

Despite the fact that plasmapheresis is safe, it still affects the patient’s condition, so to minimize possible consequences you need to follow a few simple rules.

• After the session, it is recommended to remain in a supine position for up to 1 hour, depending on your general condition.
• In the next day, you should not take hot baths, and also avoid overheating in the sun.
• It is advisable to exclude hot food and drinks.
• In some cases, bed rest is prescribed.

Price

The cost of the procedure is 1 session, ranging from 4300 to 7000 rubles. The course always consists of several procedures. As a rule, clinics provide discounts if the number of sessions is more than 5.

Reviews

Plasmapheresis is one of the most effective methods of blood purification and allergen removal. However, this method is auxiliary, since in itself it does not have any therapeutic effect. Plasmapheresis is included in complex treatment and, in some cases, in preventive measures.

Plasmapheresis is not prescribed until non-invasive treatment options have been exhausted. Be that as it may, the procedure is considered as an analogue of surgical intervention, so it is reasonable to prescribe this remedy only for appropriate indications.

Where in Russia can you get this treatment?

Plasmapheresis is offered by medical centers equipped with special rooms. There is no free plasmapheresis program.

Answers to frequently asked questions

Plasmapheresis, being at the peak of fashion, has become involved in all sorts of scandals. In fact, this is a purely therapeutic technology, unsuitable for any other purposes.

• Does the procedure have a rejuvenating effect? According to studies, plasmapheresis does not produce such an effect. Improving the condition of the skin, which is achieved with allergic dermatitis, psoriasis, and so on, is associated with the removal of allergens and immune complexes, and not at all with a real change in the skin.
• Can cleansing be used as a way to lose weight or normalize substances? Also no. There is no such definition as “slag” in medicine. Large protein molecules are removed from the plasma. Mostly it is a product of the breakdown of toxins, antibodies, antigens, etc. However, some types of peptides necessary for the normal functioning of the body also fall into this category. The latter limits both the use of the procedure and the number of sessions. It is clear that such cleansing does not affect weight in any way, and it does not normalize metabolism, since it is simply the mechanical removal of harmful substances. The source of the toxins, if associated with the disease, remains.
• Plasmapheresis and physical activity are not compatible - this statement is controversial. If we mean non-extreme loads that are familiar to a person - a fitness program that has been mastered for a long time, regular walks and jogs, then it is advisable to abandon them only on the day of plasmapheresis. If we are talking about big sports and excessive loads - preparation for a performance, for example, then plasma exchange cannot be used. Both the load and the procedure affect the heart, and the combined load may be excessive.
• Improving microcirculation in tissues is true, but only due to the fact that heparin is used when performing plasmapheresis.
• Is it possible to get rid of alcohol or drug addiction using this method? No. Moreover, plasmapheresis is not recommended for use in case of intoxication: this kind of condition is equated to neuropsychic disorders. Plasmapheresis cannot be performed in this condition. This is dangerous for the patient's life.

Plasmapheresis is a medical procedure to cleanse the blood of toxins, allergens, antigens and other things. It is prescribed by a doctor and carried out only in a hospital setting in compliance with all safety rules.

The video below will tell you whether plasmapheresis can harm the body:

Plasmapheresis - indications, contraindications or what color is the blood

Hello my dear!

This article came about because my doctor husband agreed to talk to me over dinner about professional blood cleansing.

A few days ago, when I was preparing the previous article about cleansing the body, I learned that not only the liver needs to be cleansed periodically, but also the blood, the walls of the stomach and even the pores of the skin. In that article, I collected simple recipes on how to refresh the entire body yourself at home.

Now I wanted to know if there were any advanced, professional means of blood purification. Is it possible for everyone to do them, and isn’t it dangerous?

My husband told me about this kind of professional blood cleansing over dinner. This procedure is called plasmapheresis.

Plasmapheresis

Evgeniy (husband): Plasmapheresis is a medical procedure that allows you to purify blood by dividing it into fractions or passing it through special membranes.

Foreign substances that have entered there as a result of the use of drugs, due to poor-quality food, or as a result of the breakdown of any pathogenic cells are removed from the blood. For example, in case of severe poisoning, plasmapheresis very quickly puts a person on his feet.

Me: Then I remembered the story of how Turchinsky died after plasmapheresis. Journalists on all channels have long advocated plasmapheresis. And she asked her husband a reasonable question: could this procedure cause death?

Evgeniy: This is not true. It is impossible to die from plasmapheresis. As for Turchinsky, facts were later published that journalists were no longer interested in, that the cause of death was hormonal abnormalities in the body. They led to thrombosis and early death.

Me: Is there any danger of getting infected with something during the procedure?

Evgeniy: No, the circuit of the device is closed. Everything that comes into contact with blood is exclusively disposable. There is no chance of infection at all.

Can everyone have plasmapheresis?

Evgeniy: It’s not worth doing the procedure to everyone. If you are young and healthy, then there is no point in this procedure. But how many such people do we have?

I think we will skip the indications for serious diseases and consider the indications from the point of view of cosmetology.

So, from the point of view of appearance and general well-being, plasmapheresis makes sense if you have:

• constant allergic rashes
• dermatitis
• eczema
• psoriasis
• very tired, dull skin
• unhealthy complexion

• weakness, lethargy, malaise, drowsiness.
• if you have recently undergone long-term antibiotic treatment,
• after a long serious illness, for example, pneumonia was treated for a long time.

Hardware blood purification will help remove allergens, toxins, and other harmful substances from the bloodstream and allow you to recover faster.

What waste and toxins look like

Me: Can I see what was removed during the procedure?

Evgeniy: Yes you can. Ask your doctor to show you the plasma filter before and after the procedure. You will be horrified. It will be a dark yellow dirty color. These are all things that should not be in your body.

This is bile that the body could not utilize, these are toxins, these are remnants of medications, products of the breakdown of pathological cells.

Me: Do doctors then analyze what remains on the plasma filter? Maybe some diagnoses can be made based on these residues?

Evgeniy: No, this material is not transferred to the laboratory and is not analyzed. Before hardware blood cleansing, a blood test is required to show any problems. If a doctor sent a person for this procedure, then he comes with a diagnosis already made. Cleaning is a therapeutic procedure, not a diagnostic one.

When the effect is visible

Evgeniy: The first effect of plasmapheresis occurs within a day after the first procedure. Your complexion improves - this is a secondary effect of cleansing the body. After some time, skin problems, lethargy, and weakness will go away.

Taking into account the fact that about 30% of the circulating blood volume will be cleansed at one time, the procedure must be repeated 2-3 times.

There is one nuance here - the volume of circulating blood is in communication with the cells of the body and constantly communicates with the intercellular fluid. If there is a loss of blood, the body quickly transfers intercellular fluid into the bloodstream to compensate for the missing volume.

When you have removed toxins from the bloodstream, this volume is replenished with intercellular fluid. And the intercellular fluid with all sorts of nastiness again enters the bloodstream.

On the one hand, this is good. Thanks to this, you will not only cleanse the blood, but also all body fluids.

On the other hand, because of this, only one procedure is not enough, but at least 2 are needed.

Plasmapheresis - indications contraindications

Indications

• If you have severe skin problems that cannot be treated. If you have gout. After a long illness.
• In the event that the drugs that you used in your usual doses have ceased to have an effect and you need to increase the dose more and more. For example, you used to take 1 tablet for pain relief, but now you need 3. You used to take one sleeping pill, but now you need 2.
• If you have what is popularly called “thick blood” and the risk of thrombosis is increased.
• If you have severe varicose veins, but only without trophic ulcers (tissue necrosis).
• It would be a good idea to do this procedure for people addicted to alcoholism and drug addiction.

Contraindications

• Acute stages of infectious and purulent-inflammatory diseases
• Cancerous tumor in the decay stage with bleeding
• Anemia
• Low blood clotting
• Very low blood protein levels
• Open gastrointestinal ulcer
• Membrane plasmapheresis is indicated, and in some cases necessary, for cancer patients after treatment. In contrast to the cascade procedure, which is directly contraindicated for cancer patients.

Plasmapheresis complications excluded

Plasmapheresis - technique

Evgeniy: Hardware blood purification can be membrane or cascade. The membrane lasts an hour on average. Cascade lasts 2-3 hours. The method of plasmapheresis is very simple.

The patient comes to a medical institution that has the appropriate license. He lies down on the couch and the doctor draws a portion of blood. After the purification procedure, this blood is returned to the patient. The serving size is determined by the doctor depending on the plethora of the person.

Blood is drawn from a vein as usual.

Membrane plasmapheresis

Evgeniy: Membrane plasmapheresis is a procedure for hardware blood purification using special plasma filters.

The procedure itself is simple. A portion of blood is removed from the body and passes through a device equipped with membranes. These membranes separate the blood into plasma, white blood cells, red blood cells and platelets.

The plasma, along with toxins and other toxic elements, is removed, and the remaining elements are returned to the bloodstream.

The most interesting thing will be if you ask the doctor to show the blood that was taken from you and the one that is returned to you. The difference will be visible even to the eye. After cleaning, it will be transparent, light, bright red.

Ideally, the plasma should be light, almost transparent, and it does not particularly affect the color of the blood. And the difference in color is due to the fact that due to toxins, viruses, etc. the plasma becomes dark. Instead of the removed dirty plasma, along with leukocytes, erythrocytes and platelets, they will inject you with saline. solution.

Cascade plasmapheresis

Evgeniy: A very interesting method that can really be used to rejuvenate the body is cascade plasmapheresis. Sometimes it is called double plasma filtration.

The first filter constantly provides plasma. Then the patient’s plasma, obtained on the first filter, enters the second filter, which divides the plasma into fractions. In this case, high-molecular plasma components, including all viruses, remain separately on the filter. And albumin and electrolytes return to the bloodstream.

This method was invented, developed and perfected in Japan. And it is there that he is one of the most popular.

Effect

• Restoring the rheological properties of blood - it will be the way it should be
• Microcirculation in capillaries improves significantly
• The supply of tissue with oxygen and nutrients improves,
• All viruses are removed
• The most important thing is that for people suffering from obesity, lipid metabolism disorders, vascular atherosclerosis, correction and reduction of lipid factors occurs - this is very important. In case of obesity, this is an excellent prevention of vascular condition.

Advantages of the cascade method

Evgeniy: Cascade plasmapheresis allows you to set the size of the removed plasma components, depending on which filter you install. You come with a specific problem and they select the appropriate filter for you.

You do not spend money on instilling albumins, which is sometimes required after membrane plasmapheresis, since your albumins return to the blood during cascade plasmapheresis. Moreover, these are your albumins, and not someone else’s.

You do not need to use plasma replacement solutions, since your plasma is returned to the bloodstream after purification.

Complications with plasmapheresis

Me: Can plasmapheresis cause any complications?

Evgeniy: Theoretically we can

Yes, if you have contraindications to it, but you still did this procedure. However, this is only theoretical. In practice, I am not aware of such cases.

Before the procedure, the doctor always talks with the patient and finds out if there are any contraindications. Moreover, before cleaning the blood in this way, a blood test is taken from the patient, which will show whether plasmapheresis can cause any complications or not. And if he can, then the doctor simply will not perform this procedure on you.

At what age should it be done?

Evgeniy: It should be done for medical reasons at any age. Even children with problems undergo membrane blood purification.

And if the body functions normally, then the procedure should be done after 40 years.

Duration of the procedure

Evgeniy: The procedure itself lasts from 1 to 3 hours. But you shouldn’t expect that you will get plasmapheresis and then run out shopping. After the procedure, you lie on the couch for another 1.5 hours, only after that you are released. Total, everything about everything - from 2.5 to 4.5 hours.

Doesn't it hurt?

Evgeniy: The procedure is as painful as intravenous injections are painful for you, nothing more.

How often should this be done

It is enough to undergo a course of plasmapheresis once every 2-3 years, not more often. There is no point in running around for such cleaning every six months. Toxins do not accumulate as quickly. Those who encourage you to do this more often simply want you to leave more money with them.

If there are no medical indications, then one course may include from 2-3 to 5-6 membrane procedures or 2-3 cascade plasmapheresis procedures.

The interval between procedures with membrane is from 5-10 days, with cascade - from 7-12 days. More often, without emergency medical indications, there is no point in doing it.

However, regular medical blood cleansing procedures do not replace the fact that you should eat right - eat more raw vegetables and fruits. These are our natural blood purifiers. Do not abuse fatty and fried foods.

If you are under 40 years old, or you have not yet decided to undergo plasmapheresis, you can cleanse the blood, stomach walls and liver yourself at home. There are very simple and effective recipes. Read about cleansing the body at home by following the link.

Subscribe to updates

Communication with the administration

The examination is carried out in the morning, on an empty stomach, after a minute of rest. It is recommended to refrain from smoking and drinking strong coffee at least an hour before the test.

Old price₽₽ promotion

The appointments are conducted by therapists with extensive clinical experience. Each of them is able to comprehensively assess a specific situation and select the optimal regimen for examination, treatment and prevention.

Old price₽₽ promotion

After plasmapheresis

So, you have been prescribed plasmapheresis. You have probably already become familiar with the procedure for carrying out this procedure and have completed all the necessary blood tests. Further matters are up to the medical specialists, but it’s still a good idea to know in advance what you can expect after plasmapheresis.

Plasmapheresis: essence of the procedure, types and effectiveness, indications, implementation

Depending on what problems most concern a particular person, he is treated differently. Some are waiting for a miracle, trying to restore the former beauty and purity of the skin, since they consider it to be a very effective (and safe!) means of rejuvenation, others call it a “drug first aid”, because it cleanses the blood of the breakdown products of ethyl alcohol, and still others place their last hope for a cure. a serious illness that has been bothering me for many years. Indeed, probably the most common intensive method of purifying the blood from pathological substances (toxins, circulating immune complexes - CIC, antibodies unnecessary to the body, mediators of inflammatory reactions, etc.) is plasmapheresis (plasmacytopheresis). Being widely used in various fields of medicine, therapeutic plasmapheresis is the division of blood into components (formed elements + liquid part) with further replacement of defective plasma.

plasma in the general composition of blood

In addition to plasmapheresis, in practice, both therapeutic and surgical, other methods of extracorporeal blood purification are used, for example, hemodialysis, lymphosorption, hemo- and plasmasorption, drainage of the thoracic lymphatic duct. However, almost as effective as other procedures of this kind, among the listed methods, plasmacytopheresis is noticeably superior, since it is characterized by the greatest accessibility, almost absolute safety, ease of implementation, less trauma and relatively low cost.

What is plasmapheresis?

In addition to therapeutic plasmapheresis, the purpose of which is to cleanse the blood of harmful substances, there is another type - donor plasmapheresis, intended to obtain such a valuable therapeutic agent as plasma: fresh frozen or immune, obtained from donors after their immunization and the production of antibodies to a certain antigen (staphylococcus , tetanus, etc.). But if a patient who undergoes this procedure and works only with his own blood receives his plasma (or part of it) back, then in cases of donor plasmapheresis, only the formed elements are returned to the person who gave the blood (donor), and the lost liquid part, so that BCC did not decrease and is replaced by plasma-substituting solutions. Plasma is frozen and quarantined for subsequent transfusion to sick people or becomes raw material for the production of blood products (albumin, cryoprecipitate, etc.). Of course, it is impossible to extract all the plasma from a donor, therefore plasmapheresis, carried out in blood service institutions for the purpose of procuring this valuable biological fluid, is a strictly regulated procedure. Thus, as a result of double plasmapheresis, which is the most common, ml of plasma can be obtained from a person donating his blood.

Of course, it is impossible to separate plasma from formed elements with “bare hands,” that is, without the use of certain equipment. Depending on which method was used to obtain the liquid part, there are different types of plasmapheresis:

• Sedimentation (settling method), which, in general, has become obsolete, since it does not make it possible to carry out volumetric plasmapheresis, because spontaneous sedimentation of formed elements requires quite a long time;
• Centrifugal (gravity) – convenient for obtaining donor plasma, as well as for carrying out this procedure for medicinal purposes, if another method is unavailable for some reason, since it does not require any special equipment (it is enough to have a refrigerated centrifuge and plastic containers - hemacons) ;
• Membrane (plasmafiltration);
• Hardware.

I would like to dwell on the last two types and describe them in more detail, since these are the best, but, unfortunately, not so accessible methods of blood purification.

Membrane and hardware plasmapheresis

They learned about instrumental plasmacytopheresis in Russia (then the USSR) at the turn of the last century, when it became possible to obtain blood components by automatic separation using devices - blood cell separators, which allow the procedure to be carried out in two ways depending on the type of separator: with continuous, in-line separation of blood cells and with intermittent, semi-flow separation. It would seem that the new model of plasmapheresis will completely satisfy the existing problems, but in reality everything turned out to be not so simple. Compliance with the principle of “one patient - one device” and the high cost of not only foreign equipment, but also domestic analogues, and hence their scarcity, as well as other circumstances, raised their own questions.

The situation is similar with membrane plasmapheresis (in Russia, a similar procedure debuted in the mid-70s). Membrane plasmacytopheresis is the “purification of blood” by filtering it through disposable fiber (membrane) filters. These filters allow you to separate plasma in which pathological elements are concentrated (toxins, harmful biologically active substances, fragments of cell walls, “bad” cholesterol). Equipment designed for such purposes operates automatically, has a device that allows you to control the progress of the procedure, and the process itself resembles hemodialysis.

Of course, the participation of high-tech equipment cannot be cheap, which affects the cost of treatment for the patient himself or for the medical institution that bears the costs.

The main task of membrane plasmapheresis is detoxification. Indications for the procedure are:

1. Inflammatory processes localized in the abdominal cavity and chest (acute period);
2. Infectious diseases;
3. Burns;
4. Severe injuries;
5. Poisoning.

In such situations, the immune defense is severely suppressed with the development of a kind of “immune distress syndrome.” Detoxification in such cases allows you to suppress the disease to some extent and direct the patient’s body towards recovery.

In this regard, it is also appropriate to mention such a method as cascade plasmapheresis, which was developed in the 80s of the last century. It involves re-passing plasma through special microporous filters that can not interfere with the passage of low molecular weight proteins (albumin, for example), but retain large molecules of low and very low density lipoproteins (“bad” cholesterol), which are the cause of the development of the atherosclerotic process. In addition, clinicians note the high effectiveness of cascade plasmapheresis in relation to other serious pathological conditions: myeloma, severe liver and kidney damage, hematological pathology, collagenosis and many other diseases that cannot be treated with traditional methods.

Of course, both membrane and hardware plasmapheresis are mainly the privilege of large specialized clinics, where they are used to treat patients with severe pathology. Meanwhile, it cannot be said that patients living in small settlements and in need of treatment (blood purification) are completely deprived of the opportunity to receive it. In such cases, blood purification with extraction of at least 1.5 liters of plasma is carried out in a simpler and cheaper way - centrifuge.

What is the purpose of plasmapheresis?

What does not enter the human body from the external environment: exhaust gases, tobacco smoke, toxic substances in the form of waste emitted by industrial enterprises and much more, as well as medicines, alcohol-containing liquids and drugs that people use in most cases on their own initiative. Can you imagine how the main life support organs suffer: heart, liver, lungs, kidneys? They receive a colossal load, which, moreover, affects the functioning of such important systems as the nervous, endocrine, and immune systems.

As for unhealthy people, the situation here is even worse: exposure to harmful factors only aggravates the course of the underlying disease, so blood purification in such cases becomes a paramount task. And then a safe, practically painless procedure of plasmapheresis comes to the rescue, which is used not only to rejuvenate and heal the body, improve vitality and mood, but also to treat more than two hundred diseases.

In general, the following tasks are assigned to plasmacytopheresis:

• Remove various harmful substances from the circulation: toxins, mediators of inflammatory reactions, paracoagulation products, namely, soluble fibrin-monomer complexes (SFMC), pathological antibodies, CIC (circulating immune complexes);
• Replace “bad” plasma, in which there is either a lack of normal components (blood clotting factors, immunoglobulins) or an excess of pathological antibodies;
• Bring the BCC (circulating blood volume) and rheological properties of blood to normal with further improvement of blood circulation in the microvasculature.

The reader can get acquainted with all the indications for blood purification in the next section.

Figure: normal plasma composition:

Indications

Based on many years of experience, which has revealed the undoubted benefits of plasmapheresis, clinicians rightfully consider blood purification to be a mandatory procedure in some cases, for example:

1. Paraproteinemic hemoblastoses:
2. Thrombocytopenic thrombotic purpura;
3. Septic conditions;
4. Goodpasture's syndrome (systemic capillaritis with damage to the lungs and kidneys);
5. DIC syndrome;
6. GBS (Guillain-Barré polyradiculoneuritis);
7. Multiple sclerosis (in the absence of effect from glucocorticoids);
8. DCT (diffuse connective tissue diseases) or diseases that are usually called collagenoses (RA, SLE).

Plasmacytopheresis stimulates the immune system, increases defenses and thus helps the body fight viral and bacterial infections. At the same time, blood purification reduces the risk of developing allergic reactions or prevents them altogether. Therefore, the indications for carrying out the blood purification procedure (except for those indicated above) are:

• Skin lesions (psoriasis, dermatitis, eczema, urticaria, Lyell's syndrome);
• Inflammatory processes affecting the gallbladder, liver parenchyma and pancreas;
• Ulcerative colitis and Crohn's disease;
• Amyloidosis;
• Multiple myeloma;
• Pathology of the thyroid gland;
• Bronchial asthma;
• Elimination of the consequences of chemotherapy and radiation therapy;
• Previous hepatitis B or C (membrane plasma filtration allows you to remove pathological substances - metabolites, autoantibodies);
• Diabetes mellitus (prevention of secondary complications);
• Infections, chronic inflammatory diseases of the female genital area, infertility, miscarriage, late toxicosis, prevention of Rh conflict, preparation for IVF (in vitro fertilization);
• APS (antiphospholipid syndrome);
• Heart and vascular diseases: ischemic heart disease, arterial hypertension, atherosclerotic process;
• Allergic reactions, autoimmune diseases, infections;
• Diseases of the genitourinary system in men (urethritis, prostatitis);
• Hemolytic-uremic syndrome;
• Multiple organ failure;
• Glomerulonephritis with nephrotic syndrome;
• CFS (chronic fatigue syndrome);
• Intoxication (including drugs and alcohol).

In addition, blood purification is often prescribed if previously carried out measures were not successful, and in some situations this treatment (“blood purification”) is generally perceived as an element of resuscitation, for example, in case of sepsis, acute intravascular hemolysis, and also after the person experienced clinical death.

Not strictly, but...

Meanwhile, although not strict, although not absolute, there are still some contraindications to plasmapheresis. This:

1. Chronic iron deficiency anemia (IDA), when the hemoglobin level does not rise above 90 g/l;
2. Serious lesions of the liver parenchyma, leading to disturbances in protein synthesis (total protein values ​​in a blood test do not reach 60 g/l);
3. Tumor process (however, if membrane plasmapheresis is provided for in the preparation protocol for surgery, then the procedure is not canceled);
4. Edema syndrome;
5. Exacerbation of peptic ulcer of the stomach and duodenum;
6. Problems with venipuncture caused by a congenital anomaly of the structure of the veins or vascular lesions formed as a result of numerous intravenous injections;

Considering that medicine does not note any absolute contraindications to this procedure, the issue is considered individually in each case and, if the patient’s condition, his age and the nature of the course of the concomitant pathology allow it, then, as a rule, doctors are inclined towards blood purification.

Benefits of plasmapheresis

The benefits of plasmapheresis are undeniable, because the body receives treatment and gets healthier without the use of synthetic drugs, thanks to its own resources. However, I would like to explain in more detail what positive effects this procedure brings, that is, what are the benefits of plasmapheresis. So:

• Plasmapheresis solves the problem of detoxification. Everything that has become superfluous in the body, but is concentrated in the blood, intercellular space and tissue cells (harmful biologically active substances, toxins, fragments of viral particles, remains of dead cells, etc.) leaves along with the removed plasma, which provides rest for the organs that are usually occupied with such work (liver, kidneys, lungs);
• Plasmapheresis improves the rheological properties of blood. A wide range of pathological conditions in which the blood thickens (in a blood test: the hematocrit is increased, the hemoglobin level is increased) strains cardiac activity and disrupts blood flow in the microvasculature (it is difficult for blood to overcome the narrow lumen of the vessel), which leads to chronic oxygen starvation (hypoxia). Lack of oxygen and nutrients, tissues accumulate what they could not give away - toxic metabolic products. Blood plasma, passing through a filter (membrane plasmapheresis), leaves harmful substances accumulated in the body, and is itself renewed. As a result, blood viscosity decreases, fluidity improves, and hematocrit values ​​return to normal. Of course, renewed blood will “run” faster through the vessels, reaching the most remote corners of the human body in order to provide tissues with oxygen and nutrients and take away metabolic products from them.
• Membrane plasmapheresis plays the role of an immunomodulatory factor. Pathological immunoglobulins and autoantibodies present in the plasma, which support chronic inflammation, will not be able to overcome the filter membranes and will settle on them, therefore, blood purification will help the immune system restore its lost balance. In addition, perceiving the filter and lines of the device as something foreign, the immune system begins to activate, thereby increasing the body’s defenses.

Meanwhile, patients who are prescribed a similar procedure are interested in the harm of plasmapheresis. If plasmacytopheresis is carried out correctly, the extracted plasma is adequately replaced (with intermittent plasmapheresis) with saline or colloidal (if the volume exceeds 1.5 l) solutions, then blood purification does not give anything other than positive effects. Another thing is the complications and reactions that can accompany any treatment. For example, hemodynamic disturbances such as fainting (in isolated cases, orthostatic collapse), as well as temperature reactions. However, all this can be easily stopped and is not a serious obstacle to further carrying out the procedure. During the treatment process, an exacerbation of chronic diseases that the patient has, for example, sinusitis, is possible, because the immune system comes out of a state of “hibernation”. However, this can hardly be called a harm of plasmapheresis...