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Plasmapheresis is a specialized procedure that requires medical expertise and is used to treat a variety of medical conditions, including autoimmune disorders, neurological disorders, and certain blood disorders. It involves the removal, treatment, and return of blood plasma. The process can be done using a specialized plasma filter and the dialysis machine or a separate apheresis machine which separates the blood into its components and selectively removes the plasma.

To start the procedure, the patient's vital signs and blood samples are taken to determine the appropriate course of treatment.

A trained medical staff inserts two large-bore intravenous (IV) catheters into the patient's veins or uses the dialysis catheter inserted to the neck or groin. One tube or lumen is used to withdraw blood, while the other is used to return the processed blood components to the patient.

The plasmapheresis machine is connected to the catheter, which is the same as the dialysis access, and blood is withdrawn from the patient. The machine separates the blood into its various components, including plasma, red blood cells, white blood cells, and platelets.

Plasma, which contains the targeted substances or autoantibodies that need to be removed, is separated from the other blood components using centrifugation or filtration methods. The plasma is collected and replaced with an appropriate replacement fluid, such as albumin or saline.

In some cases, the removed plasma may undergo additional treatments, such as immunoadsorption or filtration, to remove specific antibodies or harmful substances.

The processed blood components, including the treated or replaced plasma, are returned to the patient's bloodstream through the catheter. The blood components are mixed with the replacement fluid, if necessary, to maintain the appropriate volume and composition. Once the desired amount of plasma has been removed and replaced, the procedure is complete. 

The patient is monitored to ensure stability and to assess any immediate effects or complications.

Some common indications for plasmapheresis include:

  • Treatment of autoimmune disorders.
  • Management of certain neurological disorders; including chronic inflammatory demyelinating polyneuropathy (CIDP), myasthenia gravis, multifocal motor neuropathy, and certain forms of encephalitis.
  • Removal of toxins or substances.

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