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Plasma exchange (plasmapheresis)
Category: Kidney & Dialysis Procedures · All kidney & dialysis procedures
What it is
Plasma exchange removes the liquid part of your blood (plasma) — which may contain harmful antibodies or proteins — and replaces it with donor plasma or a protein solution (albumin). Blood is drawn through a line, separated by a machine, and the blood cells are returned with the replacement fluid.
Why it is done
It treats conditions driven by harmful antibodies or proteins: examples include thrombotic thrombocytopenic purpura (TTP — an emergency), some kidney diseases (anti-GBM disease, some vasculitis and transplant antibody problems), neurological conditions such as Guillain–Barré syndrome and myasthenia gravis crises, and certain blood disorders.
How to prepare
You will have blood tests including calcium, clotting and infection screening (donor plasma is used in many cases). Access is usually via a temporary central line or large-bore needles. Tell the team about allergies, especially to plasma, and about ACE-inhibitor blood pressure medicines, which are usually paused around treatments.
What happens during the procedure
You lie on a bed or recliner connected to the apheresis machine for about two to four hours while one to one-and-a-half plasma volumes are exchanged. Staff monitor you throughout; calcium is given during the exchange because the anticoagulant used binds calcium.
Afterwards — recovery & results
A course usually means daily or alternate-day exchanges for a number of sessions decided by response and blood markers. You may feel tired afterwards. Tingling around the mouth or fingers during treatment (low calcium) should be reported immediately — it is quickly corrected. Follow-up blood tests track the disease markers.
Risks & considerations
Risks include low calcium symptoms, drops in blood pressure, allergic reactions to donor plasma (uncommon), line infection or clotting, and removal of helpful substances too — clotting factors and some medicines are also cleared, which the team plans around. Your specialist will explain your individual protocol.
Watch: Plasma exchange (plasmapheresis) videos
Real procedure videos from the MedicalVideos.com library. Some clinical footage is graphic — that is the nature of a medical video library.
Related guides on MedicalVideos.com
Frequently asked questions
Is it like dialysis?
Both are blood-purification treatments on similar principles, but dialysis removes small waste molecules and water, while plasma exchange removes the plasma proteins themselves — different problems, different machines.
How many sessions will I need?
It varies by condition: TTP is treated daily until blood counts recover; antibody kidney or nerve diseases often have courses of five to seven exchanges. Your response and blood tests decide.
Related procedures — Kidney & Dialysis Procedures
Browse the P section of the A–Z list or return to the Procedures & Tests hub.