Identified cases through which plasmapheresis improves the clinical condition is:
A rapid removal of circulating factors that are directly pathogenic, such as antiGBM antibody in Goodpasture disease or light chains in multiple myeloma. In addition, plasmapheresis can reduce the inflammatory process by removing high molecular weight substances that are involved in intensifying the inflammatory process, such as complement system components and cytokines. On the other hand, with the help of plasmapheresis, it is possible to inject large amounts of plasma to the patient to replace the lost material.
Plasmapheresis improves the clearance of antibodies and immune complexes by unblocking the reticuloendothelial system. Also, by changing idiotype 0 dialysis, anti-idiotype antibody/changes the concentration of antibody to an antigen to facilitate the removal of the immune complex.
Stimulation of lymphocyte colonies and as a result of their sensitivity to cytotoxic substances used with plasmapheresis.
Therefore, to use plasmapheresis, at least one of the following conditions must be met: - Substances that must be removed from the body have a molecular weight above 15,000. Materials with lower molecular weight can be more easily removed by other methods such as hemofiltration. ـ
The pathogen material has a long half-life so that its uptake by plasmapheresis increases its clearance. For example, the half-life of IgG is approximately 21 days, and if we can completely stop its production with cytotoxic drugs, we expect its plasma concentration to decrease by 50% after 21 days.
The material to be harvested is toxic and resistant to other treatments or the effect of treatment on them is delayed. Because most diseases in which plasmapheresis is beneficial are of immunological origin, immunosuppressive therapy is usually necessary to inhibit the production of toxic substances. Factors affecting the rate of removal of toxic substances by plasmapheresis: - Lifespan of immunoglobulins: The half-life of immunoglobulins determines the amount and rate of increase in plasma levels. The ratio of intravascular to extravascular concentrations so that the more restricted the release of immunoglobulin into the vessel, the more efficient and rapid it's uptake by plasmapheresis.
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