Plasma Pheresis

Tweety, BSN, RN · Jan 17, 2003

We currently have a patient on our floor getting it. She has polyneuropathy. It is done by an outside contractor on the day shift, so I'm going to be of no help whatsoever. But she tolerates it just fine and then kind of hangs out until she gets it again. She's getting five doses every other day. (Wonder why she can't do this outpatient? But I'm sure it's an insurance, or lack thereof thing).

ageless · Jan 17, 2003

Plasmapheresis is the exchange of the patient's plasma with either plasmanate or FFPs depending on the disease process. (Good Pastures Syndrome and Guillain-Barre etc...) Yes, plasmapheresis can also be beneficial if one suspects transplant rejection. Exchange volume is based on the patient's weight..usually 3-5 liters exchanges during a treatment. A cell separator is used to extract the patient's plasma from the blood and new "plasma" is infused at the same volume and rate. This can be done out-patient as well as in-patient depending on insurance. Calcium may have to be supplimented during the procedure. I am not sure what information you are seeking..post again if you need something more specific.

jbeachy · Jan 17, 2003

Thank you ageless for your reply!

Sorry for not giving more information! I had my fiance post the first time and I think something may have gotten lost in the translation! Anyways, let me start again!

My fiance is scheduled for a kidney transplant. This will be his second one. The first was a cadaver kidney and no one can tell us for sure why it failed but they do not believe that it was due to rejection. This one is a living donor and much better suited! Since being on dialysis, etc he has also had a few transfusions. I recently read an article that mentioned using plasmapheresis on transplant patients so the rejection antibodies are not a concern. My biggest question is: does anyone know if this is being done on a prevention level? Or do they wait to see if the organ starts to be rejected prior to starting it? He, my fiance, is not too keen on doing it since he has been on dialysis for awhile and wants to be free, but if the benefits are significant I think he will do it.

Thanks for all the help!

sanakruz, ADN · Jan 17, 2003

Best wishes!

ageless · Jan 18, 2003

I have not seen the procedure done as a prophylactic measure. I have done transplants but only (after the transplant surgery) when a rejection might be emminent. Those treatments were 3-6 times a week for 3-6 weeks. It is not like the never ending chronic dialysis. It either helps or it doesn't and lab work will determine the outcome. I will continue to answer your questions if you like. You and yours remain in my prayers.

jbeachy · Jan 18, 2003

Thank you! The study I read was done at John Hopkins and I think was experimental. I was kinda hoping that it might be an option since we don't even know the original cause of the kidney failure! Not to mention, I am a pushy nurse when it comes to my loved ones and he is rather laid back about it all! Except about remaining on dialysis or anything like that! For him, dialysis has been really rough! The transplant is scheduled for Jan 27th so I am just trying to make sure all the angles are covered before!Since I am a carddiology and primary care nurse I really have to think back about kidney transplant stuff!

Thank you for your prayers!

nursemaggy · Sep 9, 2008

if anyone does it for theraputic reasons it would be united blood services or some where like that i have not heard of it being done for a transplant patient but i do know it is done as therapy for some diseases now a plasma center such as bio life or ibr would not take them as a donor as far as i know transplant is grounds for immidiate rejection as a canidate because that plasma is used to make medicine but i know some blood banks do theraputic blood draws and discard the blood now they do charge for the procedure but it isnt much not sure i was helpful but i tried now the procedure itself takes roughly an hour some places give replacement saline some dont