Plasmapheresis (from the Greek πλάσμα, plasma, something molded, and ἀφαίρεσις aphairesis, taking away) is the removal, treatment, and return or exchange of blood plasma or components thereof from and to the blood circulation. It is thus an extracorporeal therapy, a medical procedure performed outside the body.
Three general types of plasmapheresis can be distinguished:
Immunosuppression is a reduction of the activation or efficacy of the immune system. Some portions of the immune system itself have immunosuppressive effects on other parts of the immune system, and immunosuppression may occur as an adverse reaction to treatment of other conditions.
In general, deliberately induced immunosuppression is performed to prevent the body from rejecting an organ transplant. Additionally, it is used for treating graft-versus-host disease after a bone marrow transplant, or for the treatment of auto-immune diseases such as systemic lupus erythematosus, rheumatoid arthritis, Sjögren's syndrome, or Crohn's disease. This is typically done using medications, but may involve surgery (splenectomy), plasmapheresis, or radiation. A person who is undergoing immunosuppression, or whose immune system is weak for some other reasons (such as chemotherapy or HIV), is said to be immunocompromised.
Blood plasma is a light amber-colored liquid component of blood in which blood cells are absent, but which contains proteins and other constituents of whole blood in suspension. It makes up about 55% of the body's total blood volume. It is the intravascular part of extracellular fluid (all body fluid outside cells). It is mostly water (up to 95% by volume), and contains important dissolved proteins (6–8%; e.g., serum albumins, globulins, and fibrinogen), glucose, clotting factors, electrolytes (Na
, Ca
, Mg
, HCO3, Cl
, etc.), hormones, carbon dioxide (plasma being the main medium for excretory product transportation), and oxygen. It plays a vital role in an intravascular osmotic effect that keeps electrolyte concentration balanced and protects the body from infection and other blood-related disorders.
Blood plasma can be separated from whole blood through blood fractionation, by adding an anticoagulant to a tube filled with blood, which is spun in a centrifuge until the blood cells fall to the bottom of the tube. The blood plasma is then poured or drawn off. For point-of-care testing applications, plasma can be extracted from whole blood via filtration or via agglutination to allow for rapid testing of specific biomarkers. Blood plasma has a density of approximately 1,025 kg/m (1.025 g/ml). Blood serum is blood plasma without clotting factors. Plasmapheresis is a medical therapy that involves blood plasma extraction, treatment, and reintegration.
In immunology, antiserum is a blood serum containing antibodies (either monoclonal or polyclonal) that is used to spread passive immunity to many diseases via blood donation (plasmapheresis). For example, convalescent serum, or passive antibody transfusion from a previous human survivor, was the only known effective treatment for Ebola infection with a high success rate of 7 out of 8 patients surviving.
Antisera are widely used in diagnostic virology laboratories. The most common use of antiserum in humans is as antitoxin or antivenom to treat envenomation.
Immunohematology is a branch of hematology and transfusion medicine which studies antigen-antibody reactions and analogous phenomena as they relate to the pathogenesis and clinical manifestations of blood disorders. A person employed in this field is referred to as an immunohematologist or colloquially as a blood banker. Their day-to-day duties include blood typing, cross-matching and antibody identification.
Immunohematology and Transfusion Medicine is a medical post graduate specialty in many countries. The specialist Immunohematology and Transfusion Physician provides expert opinion for difficult transfusions, massive transfusions, incompatibility work up, therapeutic plasmapheresis, cellular therapy, irradiated blood therapy, leukoreduced and washed blood products, stem cell procedures, platelet rich plasma therapies, HLA and cord blood banking. Other research avenues are in the field of stem cell researches, regenerative medicine and cellular therapy.