Netaji Subhash Engineering College

[Date]

Subject- Biophysics

Topic- Technical Report On Plasmapheresis Unit

And It’s Importance In Medical Science

Name- Rupsa Khatua

Department- BME (2nd Year)
Roll No- 28
University Roll No- 10903121032
Year- 2022-23
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Introduction-
Plasmapheresis is a medical procedure designed to remove plasma from the blood. During a
plasma exchange, unhealthy plasma is swapped for healthy plasma or a plasma substitute,
before the blood is returned to the body. The blood vessels contain plasma. It is a fluid made
up of blood cells, platelets, and essential nutrients. During plasmapheresis, blood is removed
and separated into these parts by a machine. Plasmapheresis can also refer to when plasma is
removed from the body to be donated.

History Of Plasmapheresis-
On 15 February 2013 we celebrated the 100-year anniversary of the world's first successful
experimental plasmapheresis. Scientific research projects in this field were carried out by the
Department of Infectious Disease, Russian Imperial Medical Surgical Academy located in
Saint-Petersburg. Doctor of Medical Sciences and Professor Vadim A. Yurevich was a
Principal Investigator for this research, which in 1913 resulted in the discovery of a new way
of treatment. The results were published in Russki Vratch (Russian Physician) Journal no. 18
(1914) - V.A. Yurevich and N.K. Rosenberg "For the Question Regarding Washing of Blood
Outside of the Body and the Vitality of Red Blood Cells". There was no terminology offered
for this medical innovation at that time. Plasma removal was performed not solely, but in
combination with washing of blood cells returned to the patient. Nowadays this combination
is still considered to be more effective than separate plasmapheresis. According to the
published experimental protocols this new treatment was done on 15 February (2 February on
the Julian Calendar or "old style"). One year later in 1914 a famous researcher, John Abel and
Coauthors, repeated a separate plasma removal treatment with re-transfusion of the blood
cells and suggested the term "plasmapheresis", which is now official.

Different Plasmapheresis Processes-

Therapeutic Plasma Exchange (TPE)- Therapeutic plasma exchange (TPE) is an
extracorporeal blood purification technique designed to remove large molecular weight
particles from plasma. The principal mechanism of action consists of removing circulating
autoantibodies, immune complexes, cytokines, monoclonal proteins, toxins and other
inflammatory mediators .This procedure is clinically available from the early 1970s for the
treatment of several neuroimmune disorders .

Therapeutic Plasma Exchange Mechanism

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Therapeutic Plasma Exchange Machines

Disadvantages- As TPE is an extracorporeal blood purification technique, which removes
large molecular weight particles such as autoantibodies from plasma. Removing these
pathogenic substances from patient plasma, in recent years this procedure has been
increasingly indicated for hematologic, neurological, connective tissue, nephrological and
metabolic disorders.
Double Filtration Plasmapheresis (DFPP)-
Double filtration plasmapheresis (DFPP) is a newer technique in which plasma is not entirely
removed, only the antibodies, using special filters. In this process plasma, separated by a
plasma separator is then fractionated into large and small molecular weight components by a
membrane type plasma component separator. Large molecular weight components including
pathogenic substances are discarded. Small molecular weight components including valuable
substances such as albumin are returned to the patient. It may be necessary to add a small
amount of substitution fluid such as albumin.
Mechanism-
1. The large pores of the first filter membrane allow plasma, proteins and pathogens to pass
through and into the second filter.
2. The second filter, of smaller pore size, selectively removes pathogenic substances from the
plasma.
3. Substitution fluid may be added and the treated plasma is returned to the patient.
4. Pathogenic substances and some plasma are discarded.

Double Filtration Plasmapheresis

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Therapeutic Machine
Advantages-
1. More selective than Plasma Exchange.
2. Returns purified plasma to the patient.
3. Minimal loss of patient’s own desirable non-pathogenic substances.
4. Minimal Albumin loss.
5. Minimal substitution fluid required - no FFP.
6. Minimal risk of infection from substitution fluids.
7. Reduces possible protein allergy to substitution fluid.
Disadvantages-
1. Semi-selective.
2. Some “valuable” components of similar size and Molecular Weight to pathogen may
also be lost.

Immunoadsorption (IA)/ Plasma Adsorption (PA)-

Plasma, separated by a plasma separator passes through a plasma adsorption column
(IMMUSORBA / PLASORBA). Pathogenic substances are adsorbed by affinity between the
ligands and pathogenic substances. No substitution fluid is required. Immunoadsorption (IA)
is a subcategory of Plasma Adsorption (PA) because it follows the same method. It is referred
to as IA when the adsorption column selectively adsorbs immune complexes and auto-
antibodies.
Mechanism-
1. The large pores of the first filter membrane allow plasma, proteins and pathogens to
pass through and into the adsorption column.
2. The adsorption column selectively removes pathogenic substances from the plasma.
3. The treated blood / plasma is returned to the patient.
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Plasma Adsorption Mechanism

Advantages-
1. More selective than Plasma Exchange.
2. Selective removal based on Hydrophobic adsorption.
3. Ligand is harmless, physiological Amino Acid.
4. Returns purified plasma to the patient.
5. Minimal loss of patient’s own desirable non-pathogenic substances.
6. No substitution fluid required.
7. No risk of infection from substitution fluids.
8. Eliminates possible protein allergy to substitution fluid.
9. Suitable for patients with protein allergy.
Disadvantages-

1. Limited area of application.

Importance Of Plasmapheresis In Medical Science-
A plasma exchange can help to alleviate symptoms of the conditions above by removing
harmful substances from the blood.
If a person has an autoimmune condition, a plasma exchange may also prevent the body from
producing more harmful antibodies.
The procedure is usually one element of a treatment plan, which may include chemotherapy.
Repeated plasma exchanges may be necessary.