Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Process for separating corpuscular and plasmatic components of blood by differential centrifugation or membrane separation.

General definition
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  • The blood components are separated from each other due to different density. Cellular components are separated from plasma both continuously (e.g. platelet preparation) and intermittently. Membranes for plasma separation have an upper exclusion limit of about 3,000-4,000 kDa (passage of all plasma proteins is possible; cellular blood components cannot pass through). The filtrate is usually discarded.
  • Additives: Heparin, initial bolus of 2.000-5.000 IU, adjustment of PTT to 1,5 times the norm, substitution of protein loss by administration of a physiological saline solution with human albumin in a concentration of 4-5%.
    Possibly administration of 7S immunoglobulin after plasmapheresis. An additional administration of glucocorticoids or immunosuppressive drugs is not necessary as a rebound phenomenon occurs in < 0.1% of cases.
  • Exchange volume: 1.5-2.5 l of the plasma volume.
  • Frequency of treatment: Usually 2-3-day plasmapheresis cycles at 4-week intervals for an initial period of 6 months, after which the success of the therapy is monitored.

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Allergic reactions, usually related to the protein substitution solution used (fever, urticaria, chills, drop in blood pressure, hypocalcemia, toxic pulmonary edema, anaphylactic shock). If high-dose glucocorticoids or other immunosuppressive drugs are administered simultaneously, there is a risk of life-threatening infections.


Last updated on: 29.10.2020