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Apheresis is a process by which blood is removed from a patient, a portion is separated and retained, and the remainder is retransfused back to the patient.
Plasmapheresis is removal of plasma from withdrawn blood, with retransfusion of the formed elements back to the patient.
This is the process of separation and retention of a particular cell from whole blood.
In current practice these terms are often used interchangeably. Therapeutic plasma exchange (TPE) takes the actual plasmapheresis procedure one step further. Plasma is separated from whole blood and discarded, and then a replacement fluid is infused in equal volume to the plasma that was removed. Possibilities of replacement fluid could be 5% albumin, a mixture of albumin and saline, cryoprecipitate-poor plasma (CPP), or fresh frozen plasma (FFP). With TPE treatments, red blood cells, white bood cells, and platelets, along with the replacement fluid are returned to the patient.
Some of the conditions known to have been treated with therapeutic plasma exchange include:
United States Department of Health and Human Services, Centers for Medicare & Medicaid Services, NCD for Apheresis (Therapeutic Pheresis) (110.14)
The rationale for TPE is based on the fact that circulating substances, such as toxins or autoantibodies, can accumulate in the plasma. In certain diseases, autoantibodies attack healthy cells. They are created by a mix-up in the body's immune system. Also, it is hypothesized that removal of these factors can be therapeutic in certain situations. Plasma exchange is essentially a symptomatic therapy, since it does not remove the source of the pathogenic factors. Therefore the success of TPE will depend on whether the pathogenic substances are accessible through the circulation, and whether their rate of production and transfer to the plasma component can be adequately addressed by plasma exchange.