Plasmapheresis is a specialized procedure that is performed in the ICU for certain patients who are very sick with some specific kidney diseases. In this procedure large quantities of plasma is removed from a patient and replaced with fresh frozen plasma, albumin or saline.
A vascular access in the form of internal jugular catheter / femoral vein catheter / AV fistula / AV graft is required. A plasmafilter is used for the procedure. Haemodialysis machine with the blood pump and blood lines are used. Replacement fluid is infused into the blood line. Anticoagulation is used appropriately.
Some of the conditions requiring plasmapheresis are anti GBM disease, Hemolytic Uraemic Syndrome / Thrombotic thrombocytopenic purpura, cryoglobulinemia, some vasculitic processes, recurrent FSGS in renal transplant, sensitized patients waiting for renal transplant.