Plasmapheresis is ... Cascade plasmapheresis. Membrane plasmapheresis

Plasmapheresis is a method of removing blood plasma from the circulation . During the procedure, blood cells are not removed , and the plasma is replaced by blood- substitute fluids. In this case, along with the plasma, harmful substances are removed from the body (mediators of inflammation, cholesterol, lipids, endotoxins), the viscosity of the blood decreases, the sensitivity to medicines increases, and immunity is corrected.

What is plasma?

It is known that the blood consists of red and white blood cells, platelets (platelets) and a liquid in which these cell elements are present in a suspended state. Such a liquid is a solution of proteins and electrolytes and is called "plasma" (a photo is available in the article).

Methods for cleaning the plasma

Purification of the plasma can be carried out with the power of gravity or special filters. In the first case, the blood is passed through a centrifuge, in the second case, porous membrane filters are used.

For the purpose of plasma separation from blood, membrane plasmapheresis is used. In the course of the procedure, ballast cells and poisonous substances are removed from the blood. To do this, the plasma is distilled through special filters. Membrane plasmapheresis is a rather effective way of treating various diseases, due to which the internal environment of the human body changes. Medicines in this situation are powerless.

Such ailments include:

• Injuries;

• Extensive burns;

• Acute inflammatory processes of internal organs;

• Intoxication;

• Severe infection.

With the help of membrane plasmapheresis, immunity is normalized, hematopoietic cells are activated, the healing process is accelerated, the movement of blood is accelerated in the capillaries, the probability of a fatal outcome is significantly reduced.

When purifying blood from immune bodies, the symptoms of autoimmune diseases are eliminated. Clearing the blood of excess fat, you can alleviate the course of atherosclerosis. Membrane plasmapheresis makes it possible to improve the patient's well-being after an irradiation or chemotherapy procedure. It is very effective in such conditions as narcological diseases, rhesus-conflict in pregnant women, urogenital infections, the recovery period after viral hepatitis. Plasmapheresis makes it possible to minimize the likelihood of secondary complications of diabetes mellitus.

Cascade plasmapheresis is a method of purification of the blood, consisting in the passage of plasma through a special filter with sufficiently small pores. During the procedure, plasma is purified from large molecules of fats and proteins. Developed this technique was back in 1980 by Japanese scientists. Today, it is widely used to treat atherosclerosis with a large number of lipids in the blood, as well as to prevent such pathologies as a heart attack, an aneurysm, a stroke. The benefit of plasmapheresis is cascaded in systemic lupus erythematosus, rheumatoid arthritis, Crohn's disease, ulcerative colitis, myeloma and many other ailments.

Donor and therapeutic plasmaperesis

Donor plasmapheresis is a procedure that involves taking plasma from a donor (that is, in healthy people). The amount of material collected is strictly regulated by the laws on donation. Blood taken from the human body is passed through a special apparatus, the shaped elements are poured back, and the resulting plasma is subjected to conservation and used to create blood preparations or subsequent transfusion.

During the treatment procedure, up to 30% of the patient's blood is processed at a time. Her portions are withdrawn from the body, passed through the apparatus and poured back in a cleaned state.

Indications for the procedure

Plasmapheresis is not a healing procedure that can be performed by everyone in a row. This is an additional auxiliary method of treatment, when the basic therapy does not give the desired result.

In addition to the above diseases, plasmapheresis treatment is indicated when:

• Alcoholism;

• Drug addiction;

• Bronchial asthma;

• Oncological diseases;

• Ischemic heart disease;

• Angina pectoris;

• Arterial hypertension;

• Thromboembolism;

• Trophic ulcers of the digestive tract;

• Cirrhosis of the liver;

• Hepatic insufficiency;

• Glomerulonephritis with nephrotic syndrome ;

• Arterial hypertension, not amenable to drug treatment;

• Septic shock in purulent processes;

• Dermatological ailments.

Contraindications

Absolute contraindications to the procedure are a duodenal ulcer and stomach, accompanied by bleeding, and a violation of blood coagulability.

Relative contraindications include:

• Traumatic, anaphylactic and other types of shock;

• Severe liver pathology, acute form of infectious hepatitis;

• Patients older than 70 years, suffering from anemia in combination with heart disease;

• Insufficiently expressed peripheral venous network.

Possible side effects

Basically, the procedure is transferred well enough. Very rarely, a migraine-like condition or mild nausea can occur. However such unpleasant phenomena pass independently in a short time.

The procedure poses a serious danger only in the case of poor blood coagulation in the patient: bleeding may occur. In the treatment of blood to prevent its folding, use anticoagulants. With poor coagulability, such an additive can lead to complete unfolding of blood.

Applied equipment

Devices, with which plasma is separated (photo on the right), are portable and stationary. The first allow a plasmapheresis session even at the patient's home. Modern devices take small portions of blood and alternately clean them. Portable equipment is convenient in that it can easily be moved and installed near the patient's bed without transferring it for the procedure to another room.

After taking only 40 ml of blood, the blood flow is blocked by a special valve. The blood is purified and returned back to the body. Then comes a new fence. Therefore, during the procedure, there is no discomfort.

A good machine can purify and return 100 ml of blood to the body in just a minute. In this case, about 800 ml of plasma can be produced per hour.

Procedure

The duration of the procedure is about 90 minutes. No discomfort in its conduct is not felt. The patient is placed in a special chair, catheters are inserted into the veins of both hands. Then the patient can listen to music or watch TV, if there is one in the clinic. The rest will be made by the device. While the procedure lasts, the patient's condition is constantly monitored: his pressure, breathing, pulse and presence of oxygen in his blood are measured.

In one session, up to 25-30% of the blood can be cleansed, so complete cleaning requires at least 3 procedures. The amount of blood to be purified per session is determined by the physician on an individual basis, taking into account the patient's body weight, age and general condition of the body.

Purification of blood is a complex procedure, so after it is completed, the patient should be under the supervision of a specialist 30-60 minutes.

You can make plasmapheresis without any special preparation. And after the procedure, no special recommendations should be adhered to. However, in some cases, the doctor can give some advice.

Plasmapheresis in pregnancy

The procedure can be prescribed in the course of preparation for conception and for prevention purposes, and also as one of the methods of treatment. Before pregnancy, this technique is used to remove poisons accumulated in the body of a woman who smokes. If a woman is suffering from severe toxicosis during the period of gestation, then two sessions of plasmapheresis will help to significantly improve the condition of the future mother.

Plasmapheresis enables women with severe toxicosis and placental insufficiency to successfully endure and give birth to a healthy child.

This procedure reduces the risk of problems such as intrauterine infection, maleness and oxygen starvation, 1.5 times. Plasmapheresis minimizes the possibility of developing bleeding during childbirth, as blood composition is normalized and the probability of thrombus formation decreases.

In the case of severe forms of gestosis, this method gives very good results. The benefits of plasmapheresis have been proven in the following cases:

• Recurrent forms of preeclampsia;

• Insufficient effectiveness of drugs;

• Strong swelling.

Over a session, up to 40% of the blood is processed. It is necessary to conduct 2 or more procedures with a periodicity of 3-4 days.

Is the procedure dangerous?

Plasmapheresis is a practically safe procedure.

1. Use only disposable tubes, catheters. All kits are absolutely sterile and sealed.

2. The patient is constantly under the supervision of a doctor.

3. The procedure is painless. Circulatory disturbances in the process does not occur: with the contraction of the myocardium, blood is withdrawn from the body, and when it is expanded, it is poured back.

4. When plasmapheresis is not used drugs that can cause complications or side effects. Use saline solution to rinse the tubes through which the blood passes.

Plasmapheresis: the cost of the procedure

Before deciding on the procedure of plasmapheresis, you need to make sure of the good reputation of the clinic. To address should exclusively in the specialized medical institutions having a solid experience in carrying out this procedure. It should be carried out only by experienced specialists who have received special training. Suspiciously low prices for plasmapheresis should alert you. The cost of one session in the Moscow clinics is in the range of 4-5 thousand rubles. The price of a course of 5 plasmapheresis procedures averages 19-22 thousand rubles.