Therapeutic Plasma Exchange copy

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Transcript of Therapeutic Plasma Exchange copy

Dr. Nippun Prinja

Plasmapheresis Plasma exchange

TPE Healthy Donors Plasma Exchange

Crystalloids Colloids Plasma Protein Fraction FFP

Removal Of Antibodies Removal Of Immune Complexes Hyperviscosity Syndromes Removal Of toxins Replacement Of Deficient Plasma

Components

1=standard& acceptable 2=generally accepted 3=case studies 4=lacking efficacy P=phase 3 pharma trials

Manual-by use of plastic bag Automated-by cell separator machines

Reaction to replacement fluids Vasovagal reactions Pyrogenic reactions Hypocalcemia Haemolytic transfusion reactions.

THERAPEUTIC LEUCAPHERESIS THERAPEUTIC THROMBOPHERESIS THERAPEUTIC ERYTHROPHERESIS

MANUAL APHERESIS MACHINE

INTERMITTENT FLOW CENTRIFUGATION. CONTINUOUS FLOW CENTRIFUGATION.

Haemonetics Density=redcells>white

cells>platelets>plasma Seprated components from bowl through

outlet port into seprated bag Centrifuge stops and pump get reversed Components not required returned to

individual 6-8 cycles are done till desired quality &

quantity

COMTEC,AMICUS. Blood is withdrawn,processed and returned

to the individual simultaneously. Earlier two venous access,now one. Advantage of speed,small extra corporeal

volume. Isovolumeic status of donor is maintained

minimizing fluid loss.

ICU Well trained staff First aid kit Written consent Adverse effects/reaction Availability of physician if complication