plasmapheresis

[Guest guest]

My husband has MS and had a bad attack. The doctor wants to do plasmapheresis.

Has any one done this and how did it work for you.

[Guest guest]

There is some good advice about MS flares near the bottom of

http://tinyurl.com/advice-to-msers

[Guest guest]

Never had it done. Looked it up on Wikipedia. I've pasted below what it says.

One question that comes to my mind is how long does one have to be on the

immunosuppressant afterwords?

Good luck, whatever you decide.

Beverly

" Plasmapheresis

From Wikipedia, the free encyclopedia

Plasmapheresis (from the Greek & #960; & #955; & #940; & #963; & #956; & #945; - plasma,

something molded, and & #7936; & #966; & #945; & #943; & #961; & #949; & #963; & #953; & #962; -

aphairesis, 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.

The procedure is used to treat a variety of disorders, including those of the

immune system, such as Guillain-Barré syndrome, lupus, and thrombotic

thrombocytopenic purpura. Dr. D. J. Wallace states that Rubinstein was

the first person to use plasmapheresis to treat an immune-related disorder when

he " saved the life of an adolescent boy with thrombotic thrombocytopenic purpura

(TTP) at the old Cedars of Lebanon Hospital in Los Angeles in 1959 " .[1] Also

according to Wallace, the modern plasmapheresis process itself originated in the

" [u.S.] National Cancer Institute between 1963 and 1968, [where] investigators

drew upon an old dairy creamer separation technology first used in 1878 and

refined by Cohn's centrifuge marketed in 1953.[1]

Contents

[hide]

* 1 As therapy

o 1.1 Complications of plasmapheresis therapy

* 2 As a manufacturing process

* 3 References

[edit] As therapy

During plasmapheresis, blood is initially taken out of the body through a needle

or previously implanted catheter. Plasma is then removed from the blood by a

cell separator. Three procedures are commonly used to separate the plasma from

the blood cells:

* Discontinuous flow centrifugation: One venous catheter line is required.

Typically, a 300 ml batch of blood is removed at a time and centrifuged to

separate plasma from blood cells.

* Continuous flow centrifugation: Two venous lines are used. This method

requires slightly less blood volume to be out of the body at any one time as it

is able to continuously spin out plasma.

* Plasma filtration: Two venous lines are used. The plasma is filtered using

standard hemodialysis equipment. This continuous process requires less than 100

ml of blood to be outside the body at one time.

Each method has its advantages and disadvantages. After plasma separation, the

blood cells are returned to the person undergoing treatment, while the plasma,

which contains the antibodies, is first treated and then returned to the patient

in traditional plasmapheresis. (In plasma exchange, the removed plasma is

discarded and the patient receives replacement donor plasma, albumin or saline

with added proteins.) Medication to keep the blood from clotting (an

anticoagulant) is generally given to the patient during the procedure.

Plasmapheresis is used as a therapy in particular diseases. It is an uncommon

treatment in the United States, but it is more common in Europe and particularly

Japan.[citation needed]

An important use of plasmapheresis is in the therapy of autoimmune disorders,

where the rapid removal of disease-causing autoantibodies from the circulation

is required in addition to other medical therapy. It is important to note that

plasma exchange therapy in and of itself is useful to temper the disease

process, where simultaneous medical and immunosuppressive therapy is required

for long-term management. Plasma exchange offers the quickest short-term answer

to removing harmful autoantibodies; however, the production of autoantibodies by

the immune system must also be suppressed, usually by the use of medications

such as prednisone, cyclophosphamide, cyclosporine, mycophenilate mofetil,

rituximab or a mixture of these.

Other uses are the removal of blood proteins where these are overly abundant and

cause hyperviscosity syndrome.

Examples of diseases that can be treated with plasmapheresis:

* Guillain-Barré syndrome

* Chronic inflammatory demyelinating polyneuropathy

* Goodpasture's syndrome

* Hyperviscosity syndromes:

o Cryoglobulinemia

o Paraproteinemia

o Waldenström macroglobulinemia

* Myasthenia gravis

* Thrombotic thrombocytopenic purpura (TTP)/hemolytic uremic syndrome

* Wegener's granulomatosis

* Lambert-Eaton Syndrome

* Antiphospholipid Antibody Syndrome (APS or APLS)

* Microscopic polyangiitis

* Recurrent focal and segmental glomerulosclerosis in the transplanted

kidney

* HELLP syndrome

* Refsum disease

* Behcet syndrome

* HIV-related neuropathy [2]

* Graves' disease in infants and neonates

* Pemphigus vulgaris

* Multiple sclerosis

* Rhabdomyolysis

[edit] Complications of plasmapheresis therapy

Though plasmapheresis is helpful in certain medical conditions, like any other

therapy, there are potential risks and complications. Insertion of a rather

large intravenous catheter can lead to bleeding, lung puncture (depending on the

site of catheter insertion), and, if the catheter is left in too long, it can

get infected.

Aside from placing the catheter, the procedure itself has complications. When

patient blood is outside of the body passing through the plasmapheresis machine,

the blood has a tendency to clot. To reduce this tendency, in one common

protocol, citrate is infused while the blood is running through the circuit.

Citrate binds to calcium in the blood, calcium being essential for blood to

clot. Citrate is very effective in preventing blood from clotting; however, its

use can lead to life-threatening low calcium levels. This can be detected using

the Chvostek's sign or Trousseau's sign. To prevent this complication, calcium

is infused intravenously while the patient is undergoing the plasmapheresis; in

addition, calcium supplementation by mouth may also be given.

Other complications include:

* Potential exposure to blood products, with risk of transfusion reactions

or transfusion transmitted diseases

* Suppression of the patient's immune system

* Bleeding or hematoma from needle placement "

>

> My husband has MS and had a bad attack. The doctor wants to do plasmapheresis.

Has any one done this and how did it work for you.

>