Plasmophoresis – indications for use in gynecology, during pregnancy, allergies, psoriasis. Possible side effects, price of the procedure

Plasmophoresis is a modern technology for cleaning the circulatory system of pathogenic plasma. Therapy is indicated for use in many diseases, and has a minimum of contraindications.

The concept of plasmophoresis and its types

Plasmapheresis is a blood purification method. A small amount of biological fluid is taken from the circulatory system, passed through a special device that divides it into plasma and shaped blood elements. The bioplasma is removed, and other components are introduced back into the bloodstream.

Simultaneously with blood sampling, it is replaced with special solutions that are selected, given:

• the condition of the patient;
• the nature of the disease;
• amount of plasma removed.

Depending on the purpose, the procedure is divided into 2 types:

1. Therapeutic – carried out for the purification of blood containing allergens, autoantibodies and toxins. The procedure reduces the concentration of harmful elements in the patient’s body. It is considered part of detoxification treatment.
2. Donor – blood separation for healthy people for further transfusion to needy patients, or for the manufacture of necessary drugs.

Plasmapheresis is divided into varieties:

• sedimentary – detachment of the bioplasm is accomplished through sedimentation, here the blood cells sequentially go into sedimentary material;
• centrifugal – the separation procedure is accelerated by the action of centrifugal force on the shaped particles of blood;
• filtration – using special plasma filters;
• membrane – special thin lamellar membranes are used that transmit plasma and retain blood cells;
• cascade – the extracted liquid red part is secondly filtered through a special device to pass albumin (low molecular weight protein) and delay lipoproteins (high molecular weight protein).

Classification

The procedure is classified in 3 directions:

• appointment;
• cleaning method;
• technology conducting.

The intended category includes therapeutic and donor plasmophoresis, as well as cryophoresis, during which the plasma is first frozen, and then administered to the patient again after freezing.

According to the cleaning method, the procedure is divided into 2 groups. One of them is manual (discrete), in which a large amount of blood is extracted at a time, sent to a specially disinfected container, and cleaned.

Cells that remain after plasma withdrawal are dissolved in physiological saline and poured into the patient again. This category includes sedimentation and centrifugal methods.

The second group includes a hardware fence, which is characterized by continuous cleaning and return of blood. Here, the red liquid is taken in small doses, delivered to the separator and returned also in small portions. This technique is much more easily tolerated by humans, because it does not form a load. The cascade and membrane phoresis belong to the hardware form.

According to the technology, there are 2 methods for performing plasmapheresis. The most common of them – with the help of centrifuges, which are configured by programs, while maintaining high-precision speed of rotation and braking.

This contributes to the good preservation of blood cells, as well as the carbohydrate and protein components of the plasma. After a centrifuge, blood particles supplemented with the necessary substances or purified bioplasma are introduced into the patient’s body.

The second method, safe and painless, involves separation through membrane filters. Red liquid reaches a special container and is filtered. In this case, harmful substances are disconnected together with the plasma.

Pros of the procedure

Plasmophoresis (an indication for use has been established for many diseases) has the advantages of:

• cleanses the body of existing toxic substances (antigens, allergens, pathogens of inflammation);
• for some pathologies, this technique is necessary (severe poisoning, blood poisoning, destabilization of the liver);
• improves the circulatory composition, suppresses acute manifestations of allergies;
• the blood fluid becomes not so viscous, blood circulation is stabilized, while nutrition and oxygen enter all body tissues;
• It has a minimum of side effects, complications are rare;
• when taking blood, fluid from nearby tissue structures is sent to the vessels to replenish the volume, which prevents the appearance of various edema.

Cons of plasmapheresis

The disadvantages of such therapy depend on the features of its implementation.

1. The effect after cleaning is short, if we talk about the disease. For example, with poisoning, 1-2 manipulations are enough to remove toxins. In the case of further receipt of toxic substances, the result is valid for a day, and this means that the procedure should be followed by a course consisting of a minimum of 10 sessions.
2. The high cost of plasmapheresis. Some methods of its implementation differ in price. So the gravitational method is much cheaper than the cascade method.
3. The technique has some contraindications, in which, along with toxins, the necessary proteins are excreted (fibrinogen, immunoglobulin).

Indications for gynecology, medicine

Plasmophoresis (the indication for use is determined by the doctor) in medicine is carried out under conditions:

• overdose of medicines;
• increased blood viscosity;
• hypereffect from the effects of hormonal drugs;
• the presence of toxins in the liver;
• increased risk of thrombosis;
• insulin resistance in people with diabetes;
• with ailments of blood vessels and heart;
• in case of failures in the digestive tract;
• for patients with acute manifestations of asthma, pneumonia and alveolitis;
• skin diseases (herpes, eczema, psoriasis);
• with impaired functioning of the endocrine system;
• ophthalmic ailments of an inflammatory nature (pseudotumor, uveitis), as well as retinopathy;
• deviations in the activity of the central nervous system (infection of viral origin, encephalitis, sclerosis).

Plasmophoresis has such indications for use in gynecology:

• to prevent and reduce toxicosis in the first months of pregnancy;
• if there is a risk of a Rhesus conflict between the unborn child and the body of the bearing woman;
• if the patient had miscarriages due to an
  autoimmune disease or due to pathology in the blood coagulation system;
• with placental insufficiency;
• as a treatment for cytomegalovirus and herpes during pregnancy planning and bearing a child;
• to reduce excessive ovarian stimulation, which often appears after IVF;
• to reduce discomfort during the period of PMS and menopause;

  

• if a woman carrying a fetus has such ailments as asthma, pyelonephritis and diabetes;
• in case of postpartum complications;
• with infertility, which arose due to chronic inflammatory processes;
• to prevent and treat bleeding, and even with multiple organ disorders;
• as a recovery method following surgical procedures on the pelvic organs;
• therapy of chronic diseases of the appendages and uterus.

Contraindications to plasmapheresis

The procedure is contraindicated in some moments, namely:

• in the presence of irreparable damage to organs;
• with ongoing bleeding;
• imbalance in the blood coagulation system;
• stomach ulcer;
• heart rhythm dysfunction;
• fluctuations in blood pressure;
• low blood viscosity, monthly discharge;
• acute chronic diseases;
• anemia in aged patients;
• serious liver ailments;
• uncompensated hypoproteinemia;
• prolonged use of anticoagulants;
• fever, shock conditions;
• foci of purulent lesions;
• inflammation of the venous network.

Negative effect on the body

Plasmapheresis negatively affects the body in cases of:

• when you enter medications that stop the formation of blood clots, and even donated plasma, an allergy can occur, reaching anaphylaxis;
• if a large amount of blood is withdrawn using the manual method, blood pressure can drop sharply;
• with the injection of anti-clotting agents, bleeding may occur, or thrombosis occurs when the dosage is insufficient. In this case, blood clots can spread and penetrate into vessels with a smaller size;
• if the technology of the procedure is violated, there is a risk of infection;
• when replacing saline with plasma from a donor, there is a chance of kidney failure;
• when deviating from aseptic rules, sepsis may develop;
• removal along with toxins of useful elements;
• a short decrease in immunity;
• metabolic disorders;
• headache.

Features of the method in the treatment of psoriasis, allergies

Plasmophoresis (application to the indication should be established by a qualified doctor) is used in allergy therapy. In this case, unnecessary factors of immune activity, negative components and chemical elements are removed from the body simultaneously with plasma. Here, the effect is made on the development of a protective reaction, and on the mechanism that causes allergies.

The duration of the therapeutic course for this disease is from 3 to 5 sessions. After passing through the patient, the signs of allergy become much less. It is worth considering that this procedure is one of the parts of the complex therapy of this ailment. The effect after the sessions lasts 6-12 months.

With psoriasis, plasmacytophoresis in addition to toxic elements formed as a result of impaired or increased metabolism.

The elements represented by:

• viruses;
• unoccupied hemoglobin;
• bacterial endotoxins.

The procedure involves the use of special filters, a centrifuge may be used. These devices have plastic containers with blood, 16,91 fluid ounce in size.

Gravitational forces distribute red fluid to isolated blood cells that return to the patient’s bloodstream. The removed plasma is disposed of. In the treatment of psoriasis, plasmophoresis can be replaced by plasma exchange, in which 90% of the plasma circulating in the body is replaced.

The method for the disease rather well increases the efficiency of the body, protects it from the effects of pathogenic factors, increases the level of stress resistance.

Plasmophoresis during pregnancy

Plasmofaresis (an indication for use during pregnancy is permissible) is prescribed in such cases:

1. Women who smoke to cleanse the blood and remove toxins.
2. Toxicosis patients feel much better after several sessions.
3. With placental insufficiency.
4. In 1.5 time. the number of intrauterine infections and the appearance of children with low weight are reduced.
5. The risk of thrombosis and bleeding during childbirth is reduced, because the blood composition is normalized.
6. In the presence of a Rhesus conflict, the technique will reduce the number of antibodies to a normal level.

During the period of gestation, the extracorporeal procedure has contraindications:

• the presence of pathologies of a viral or infectious nature;
• at risk of miscarriage or the onset of premature labor.

Training

An extracorporeal procedure lasts at least an hour, and before it is carried out, the patient must undergo a thorough examination, which includes:

• therapeutic examination to measure blood pressure, heart rate readings, detection of ulcerative ailments, and other chronic diseases;
• make a blood test for glucose indicators , for the manifestation of the Wasserman reaction – to exclude the presence of syphilis;
• blood fluid biochemical testing – to assess the presence of proteins, to make sure the absence of hypoproteinemia. With plasmapheresis, a group of proteins is excreted simultaneously with plasma, and if they are insufficiently concentrated, it is advisable to refuse sessions;
• coagulogram – assesses blood coagulation, with the formation of blood clots – the method is indicated for use;
• ECG – with large failures in the rhythm of the heart, the procedure is not allowed.

A few days before such therapy, it is necessary to exclude the use of caffeine, alcohol and drink plenty of fluids. Before starting a session, it is advisable to eat a balanced and light meal.

Step-by-step procedure

When conducting plasmapheresis, there are no inconveniences, the therapy is performed in a specially equipped room.

1. The patient is placed on a chair in a lying or reclining position.
2. A catheter or needle is inserted into the ulnar vein, with the help of which blood is taken.
3. In modern installations, 2 needles are put: blood fluid tissue is taken through one of them, and through the other it is again introduced into the human body.
4. Red liquid is transferred to a hemo container, then divided into fractions. The method of division depends on the type of apparatus used. Meanwhile, the plasma is removed, while replacing it with saline or other blood substitutes, in an appropriate volume.
5. Together with the return of blood, the administration of prescribed medications is possible.

The duration of the session is 1-2 hours. The amount of purified blood is determined depending on the method of purification and the advice of a doctor. The manipulation is performed by a specially trained transfusiologist or anesthetist. For 1 session, on average, 30% of the total blood volume in the body is cleared.

During the procedure, a doctor or nurse is present nearby. The patient’s condition is continuously monitored: blood composition, blood pressure and heart rate are measured.

Consequences and Complications

Each person has an individual organism, so plasmapheresis can sometimes cause complications and consequences:

1. The manifestation of allergies, which comes to anaphylactic shock (appear when injecting substances that prevent the formation of blood clots into the bloodstream).
2. Hypotension (occurs when a large volume of blood is withdrawn from the patient’s body at once).
3. Bleeding (occur due to excess dosage of drugs that lower the ability of blood coagulation).
4. Thrombosis (appear as a result of an insufficient portion of the above funds).
5. Bloodstream infection (is a consequence of aseptic rule violations, mainly with the manual method of plasmophoresis).
6. Renal failure (develops when replacing plasma with a donor plasma, while it is not compatible with the blood of the patient undergoing the procedure).
7. Mortality rates after complications: 1 patient out of 5000.

Rehabilitation period

In the first day after therapy, you should adhere to the recommendations:

• within 1 hour after therapy to be in a prone position, taking into account the general condition;
• exclude the use of hot baths;
• do not eat hot food and drinks;
• refrain from exposure to the sun and prevent overheating;
• adhere to bed rest.

If the extracorporeal procedure is done correctly, then, as a rule, complications are not traced. Sometimes there is a slight dizziness and nausea, which soon disappear.

If the malaise worsens, swelling and itching occur in the injection area, joint pain and shortness of breath, you should consult a specialist as soon as possible.

Table of the average cost of 1 session in New York, Los Angeles,

Method	City	Cost, usd.
Membrane	Saint petersburg	5000-8000
	New York	6000-8000
	Detroit	6000
	Las Vegas	7000-8000
	Atlanta	6000-7000
	Las Vegas	4000-5000
	Detroit	5000-6500
Discrete	Saint Petersburg	3000-6000
	New York	5000-6000
	Detroit	2000-3000
	Las Vegas	4000-5000
	Atlanta	3000-5000
	Las Vegas	3000-4000
	Detroit	2000-4000

Reviews of doctors about the effectiveness of plasmapheresis

Doctors’ opinions about the effectiveness of plasmapheresis are different, but mostly positive:

• the main positive result is the purification of blood from toxins that contribute to the exacerbation of pathology;
• blood circulation in the affected area is normalized;

  

• pain is reduced;
• the need for medical treatment for the patient is reduced;
• the concentration of immunoglobulin and immune complexes in the human body is regulated;
• a good chance to seamlessly switch from one medication to another if necessary;
• It is a good alternative in the treatment of arthritis if a person is allergic to any medication of standard treatment;
• as a rule, the inefficiency of the technique is explained by the severity of the disease, when one extracorporeal procedure is not enough;
• negative aspects of the blood purification technique appear if the patient suffers from dermatological diseases;
• deterioration in well-being occurs with inaccurate removal of the patch securing the needle;
• for an effective result, you need to complete the full course of the prescribed treatment.

Plasmophoresis alone does not guarantee a cure for diseases. If the method is indicated for use, it is advisable to combine it with drug therapy.

For a visible result, you must complete the full course of treatment prescribed by a qualified specialist.

Video about plasmophoresis

Work plasmapheresis:

What is plasmapheresis: