Plasmapheresis or — plasma exchange — is a process involving the following steps:
- Whole blood is withdrawn from a large vein
- A machine separates the liquid portion of blood (plasma) from the red and white blood cells.
- The cells are transfused back along with a plasma replacement fluid.
This exchange, sometimes referred to as a “blood-cleansing procedure,” is a successful method for treating some autoimmune diseases — such as myasthenia gravis and Guillain-Barré syndrome — because it removes the circulating antibodies that are thought to be active in these diseases. Although studies of plasmapheresis as a disease modifying treatment for MS did not find the procedure to be effective, studies do indicate that plasmapheresis may be beneficial for individuals experiencing a relapse that has not responded adequately to corticosteroids. Side effects of plasmapheresis therapy include occasional infection and blood clotting problems.
Irene Cortese, MD, and colleagues from the Therapeutics and Technology Assessment Subcommittee of the Academy of Neurology (AAN), reviewed the medical literature from 1995 through 2009 to reassess the role of this strategy for treating neurologic disorders, and revised the previous set of AAN guidelines to include recommendations for MS. The new guidelines appear in Neurology (2011;76(3):294-300.