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Plasmapheresis Overview

Plasmapheresis is a process in which the fluid part of the blood, called plasma, is removed from blood cells by a device known as a cell separator. Blood plasma contains many vital proteins including fibrinogen, globulins and human serum albumin. Sometimes blood plasma may contain viral impurities which must be extracted through viral processing. A simple way to separate plasma from blood cells in a blood sample is by centrifugation.

The antibodies are part of our immune system that helps us to fight many diseases, some of them serious, moderate, or milder, which we undergo everyday. 

What happens though when due to some diseases the antibodies don’t recognize each other anymore and so they start fighting the organism and the immune system cannot respond?

Plasmapheresis is basically used to take away some of the antibodies from the blood, thus not allowing them to fight the organism.

At first, blood is initially taken out of the body through a needle or previously implanted catheter. Some of the plasma is then removed from the blood by a cell filter. After plasma separation, the blood cells are returned to the person undergoing treatment, while the plasma, which contains the antibodies, is replaced with other fluids. It is thus an extracorporeal therapy.

Using simple terms, plasmapheresis means the removal of the “bad” components of plasma form the blood, their treatment and the return of already now the “good” ones in the blood. Plasmapheresis is used to remove antibodies from the bloodstream, thereby preventing them from attacking their targets. Neurological diseases comprise 90% of the diseases that could profit from plasmapheresis as well as any myopathies. 

Connective tissue diseases and autoimmune diseases see major benefits from plasmapheresis.

Plasmapheresis treatment

A plasmapheresis treatment takes several hours and can be done on an outpatient basis. It can be uncomfortable but is normally not painful. 

The number of treatments needed varies greatly depending on the particular disease and the person's general condition. An average course of plasma exchanges is six to 10 treatments over two to 10 weeks. In some centers, treatments are performed once a week, while in others, more than one weekly treatment is done.

A person undergoing plasmapheresis can lie in bed or sit in a reclining chair. A small, thin tube (catheter) is placed in a large vein, usually the one in the crook of the arm, and another tube is placed in the opposite hand or foot (so that at least one arm can move freely during the procedure). Blood is taken to the separator from one tube, while the separated blood cells, combined with replacement fluids, are returned to the patient through the same tube.