PLASMAPHERESIS :(from the Greek plasma, something molded, and apheresis, taking away) is the removal, treatment, and return of (components of) blood plasma from blood circulation. It is thus an extracorporeal therapy. The method can also be used to collect plasma for further manufacturing into a variety of medications
Pheresis (pronounced as fur-ee-sis) is a special kind of blood donation by which specific components of the blood can be separated. It came from a Greek word meaning 'to take away' or 'separate'. By this method, the blood components like plasma, erythrocytes, platelets, granulocytes (neutrophils and basophils), and agranulocytes (lymphocytes and monocytes) can be separated. The pheresis is done using a machine called a cell separator. The separation is based on density gradient centrifugation The separated components are collected in separate vials or specialized polythene bags in the machine.
The pheresis procedure, or apheresis, is often used to obtain stem cells from the peripheral blood of a person having a blood disease (such as leukemia), which are at a later time reinfused (often after some sort of processing) into that patient's bloodstream in a procedure known as an autologous bone marrow transplant. In this type of transplant, the sick person is his own donor. Similarly, the procedure is often used to obtain stem cells from a healthy person in a procedure known as an allogeneic bone marrow transplant. In this type of transplant, another person (whether related or not) is the donor.
THIS CAN BE USEFUL IN THE TREATMENT OF MYASTENIA GRAVIS ... The purpose of this study was to compare the efficacy of high-dose intravenous immunoglobulin (IVIG) treatment with plasma exchange in patients suffering from moderate to severe myasthenia gravis (MG) in a stable phase. There are no controlled studies comparing IVIG with plasma exchange in patients who despite immunosuppressive treatment have persistent incapacitating MG symptoms. This was a controlled crossover study. Twelve patients with generalized moderate to severe MG on immunosuppressive treatment for at least 12 months were included. The patients were evaluated clinically using a quantified MG clinical score (QMGS) before and at follow-up visits after each treatment. One week after the treatments, the patients who received plasma exchange treatment showed a significant improvement in QMGS compared to baseline but although some improvement was seen after IVIG this did not reach statistical significance. Four weeks after both plasma exchange and IVIG treatments, there was a significant improvement in QMGS compared to baseline. One week and 4 weeks after treatment, no significant difference between the 2 treatments was found. Both treatments have a clinically significant effect 4 weeks out in patients with chronic MG, but the improvement has a more rapid onset after plasma exchange than after IVIG.
Myasthenia gravis (MG) is a prototype of antibody-mediated autoimmune disease in which antibodies against the nicotinic acetylcholine receptor (AChR) cause a reduction of junctional AChR, resulting in a defect of neuromuscular transmission. Plasmapheresis has contributed to elucidate the immune pathomechanism in MG as well as being established as effective treatment. Nowadays, plasmapheresis coupled with immunosuppressive treatment has been used to treat severely affected patients. Plasmapheresis appears to be effective and shorten the duration of MG crisis, although it is still unknown whether plasmapheresis improves the prognosis of MG. Clinical improvement induced by plasmapheresis occurs as a result of the accumulation of newly synthesized AChR after decrease in the rate of antibody-mediated AChR loss. This effect usually appears from at least 2 day after plasmapheresis. However, in the clinical setting we occasionally experienced rapid improvement of myasthenic symptoms just after plasmapheresis. Amelioration of functional block of AChR may explain, at least partly, the rapid recovery after plasmapheresis. To remove circulating anti-AChR antibodies, immunoadsorption plasmapheresis has been recognized as a safe and effective method in which no replacement fluid is necessary While several uncontrolled trials convincingly showed that plasmapheresis can provide rapid but relatively short-term improvement, very few controlled trials have been carried out. Therefore, randomized controlled trials would be required to determine the appropriate treatment regimen for MG.