Therapeutic Plasma Exchange

1. Dr. Nippun Prinja

2.  Plasmapheresis
 Plasma exchange

3.  TPE
 Healthy Donors Plasma Exchange

4.  Crystalloids
 Colloids
 Plasma Protein Fraction
 FFP

5.  Removal Of Antibodies
 Removal Of Immune Complexes
 Hyperviscosity Syndromes
 Removal Of toxins
 Replacement Of Deficient Plasma
Components

6.  1=standard& acceptable
 2=generally accepted
 3=case studies
 4=lacking efficacy
 P=phase 3 pharma trials

7.  Manual-by use of plastic bag
 Automated-by cell separator machines

8.  Reaction to replacement fluids
 Vasovagal reactions
 Pyrogenic reactions
 Hypocalcemia
 Haemolytic transfusion reactions.

9.  THERAPEUTIC LEUCAPHERESIS
 THERAPEUTIC THROMBOPHERESIS
 THERAPEUTIC ERYTHROPHERESIS

10.  MANUAL
 APHERESIS MACHINE

11.  INTERMITTENT FLOW CENTRIFUGATION.
 CONTINUOUS FLOW CENTRIFUGATION.

12.  Haemonetics
 Density=redcells>white
cells>platelets>plasma
 Seprated components from bowl through
outlet port into seprated bag
 Centrifuge stops and pump get reversed
 Components not required returned to
individual
 6-8 cycles are done till desired quality &
quantity

14.  COMTEC,AMICUS.
 Blood is withdrawn,processed and returned
to the individual simultaneously.
 Earlier two venous access,now one.
 Advantage of speed,small extra corporeal
volume.
 Isovolumeic status of donor is maintained
minimizing fluid loss.

17.  ICU
 Well trained staff
 First aid kit
 Written consent
 Adverse effects/reaction
 Availability of physician if complication