Therapeutic Plasma Exchange: What to Expect
During this therapy, small amounts of blood are gradually removed through an inserted needle or central line catheter and circulated through a machine that separates blood into red cells, white cells, platelets, and plasma.
The plasma portion of the blood is removed and replaced by a plasma substitute and then added back to the cells (red cells, white cells, and platelets) and finally returned by intravenous or central venous catheter access. The removed plasma is discarded.
One procedure typically removes 65% to 70% of the disease-causing proteins (antibodies) in the plasma. Typically, several procedures are needed to lead to clinical improvement.
Plasma exchange is a safe procedure with a few possible side effects.
Before TPE
Prior to a procedure, we recommend that patients drink large amounts of noncarbonated, nonalcoholic beverages for a couple of days. We also recommend eating a meal prior to the scheduled procedure.
During TPE
If intravenous catheters (IVs) are placed, patients’ arms will be propped on pillows, and they will be asked to squeeze their fist to help promote blood flow. Patients may experience bruising or discomfort where the IVs are placed. If a larger catheter or port is used instead, patients will have free use of their arms during the procedure.
The procedure typically lasts two to three hours but can be shorter or longer depending on a variety of factors.
After starting the procedure, patients may experience some mild numbness, tingling, light-headedness, or nausea. An apheresis staff member who specializes in the procedure will be with the patient during the entire treatment. Patients should tell their nurse of any side effects or symptoms they feel.
After TPE
After the procedure is completed, patients may feel tired for the rest of the day. We recommend drinking plenty of liquids after the procedure. We also recommend that patients have a family member or friend give them a ride home.