Name of the Procedure:

Therapeutic apheresis; with extracorporeal immunoadsorption, selective adsorption or selective filtration and plasma reinfusion

Summary

Therapeutic apheresis is a procedure that removes harmful components from the blood. In this specific method, blood is drawn out of the body, processed through a machine that selectively removes unwanted substances, and the cleaned blood is reinfused back into the patient.

Purpose

This procedure addresses autoimmune diseases, certain types of cancers, and other conditions where harmful substances circulate in the blood. The goal is to reduce or eliminate these harmful elements, thereby alleviating symptoms and improving the patient's health.

Indications

This procedure is indicated for patients with conditions like myasthenia gravis, Guillain-Barré syndrome, multiple sclerosis, certain cancers, and severe autoimmune disorders. It is appropriate for patients who have not responded to conventional treatments, or who need rapid removal of disease-causing agents from the blood.

Preparation

Patients may be advised to fast for several hours before the procedure. Medications may need to be adjusted, and patients will undergo preliminary blood tests and assessments to determine their suitability for the procedure.

Procedure Description

1. Preparation: An intravenous (IV) line is inserted into the patient’s vein.
2. Blood Withdrawal: Blood is drawn from the patient and passed through a specialized machine.
3. Selective Filtration: The machine selectively adsorbs or filters out the harmful substances from the blood.
4. Reinfusion: The cleaned blood components are mixed with plasma and reinfused into the patient. The procedure typically uses advanced technology and may involve the use of selective adsorbents or filters. Depending on the case, local anesthesia may be used for the insertion of catheters.

Duration

The procedure usually takes about 2 to 4 hours.

Setting

It is typically performed in a hospital or specialized outpatient clinic equipped for apheresis.

Personnel

The procedure involves a team of healthcare professionals, including a hematologist, a specialized nurse, and sometimes an anesthesiologist.

Risks and Complications

Common risks include bleeding, infection at the catheter site, and low blood pressure. Rare complications might include allergic reactions, electrolyte imbalances, and blood clotting issues. These risks are managed through careful monitoring and immediate medical support.

Benefits

The primary benefit is the rapid removal of disease-causing agents from the blood, leading to symptom relief. Benefits are usually noticed within days to weeks following treatment.

Recovery

Post-procedure, patients are monitored for any immediate side effects. They are advised to rest and avoid strenuous activities for 24 to 48 hours. Follow-up appointments are necessary to monitor the patient's response and progress.

Alternatives

Alternative treatments include medication, traditional plasma exchange, and immunosuppressive therapies. These options have varying degrees of effectiveness and side effects, and the choice depends on the individual patient's condition and response to prior treatments.

Patient Experience

During the procedure, some patients might feel lightheaded or experience mild discomfort at the IV site. Post-procedure, patients may feel tired but usually recover quickly with adequate rest and hydration. Pain management strategies include local anesthetics and comfort measures provided by the healthcare team.