Chapter 27 Plasmaphoresis Flashcards
What is plasmapheresis?
A procedure involving the extracorporeal separation of blood components to obtain a filtered plasma product.
What is the basis for therapeutic plasmapheresis (TP)?
The removal of proteins, protein-bound or high molecular weight solutes including autoantibodies, immune complexes, excess lipids, hormones, aromatic amino acids, ammonia, bilirubin, endotoxin, lipids, phenols, and exogenous toxins.
What are the two common methods for preparing plasma products in equine medicine?
Manual blood centrifugation and gravity sedimentation.
What is automated plasmapheresis?
A procedure using in-line blood cell separators to remove whole blood, infuse anticoagulant, and separate blood components via centrifugation, returning concentrated cells to the donor.
What are the advantages of automated plasmapheresis over manual methods?
It is more efficient, reduces erythrocyte and leukocyte counts, minimizes the risk of immunological and non-immunological adverse reactions, and maintains normal coagulation activity.
What is the main goal of apheresis?
To separate one or more blood components and return the remaining products to the patient or donor, with or without extracorporeal treatment or replacement of the separated component.
What are the categories of apheresis applications according to the American Society of Apheresis?
Category I: first-line therapy, Category II: second-line therapy, Category III: uncertain role, Category IV: ineffective or harmful.
What is the primary use of therapeutic plasmapheresis in human and veterinary medicine?
To remove disease-causing or disease-related plasma components from circulation and replace them with harmless plasma.
What types of solutes does therapeutic plasmapheresis primarily remove?
Protein-bound or high molecular weight solutes such as circulating protein-bound toxins, autoantibodies, immune complexes, and abnormally occurring molecules.
What are the conditions for which therapeutic plasmapheresis has been used in human medicine?
Immune-mediated diseases, neoplasia, infectious diseases, sepsis, hyperlipidemia, thyrotoxicosis, and removal of toxins.
What are the indications for using therapeutic plasmapheresis in equine medicine?
Conditions such as immune-mediated hemolytic anemia, immune-mediated dermatoses, purpura hemorrhagica, hypertriglyceridemia, liver failure, kernicterus, sepsis, and multiple organ dysfunction syndrome.
What is the role of therapeutic plasmapheresis in immune-mediated hemolytic anemia?
It removes circulating autoantibodies, immune complexes, and activated complement components in patients with poor response to blood transfusions and life-threatening hemolysis.
What is pemphigus foliaceus and its treatment challenge?
A common autoimmune skin disease in horses that may take weeks to months to control with glucocorticoids and/or azathioprine.
What was the author’s experience using TP in equine patients with pemphigus foliaceus?
TP was applied to four adult equine patients unresponsive to high doses of dexamethasone, showing clinical improvement with lower doses of dexamethasone after TP.
What is purpura hemorrhagica?
An immune-mediated severe necrotizing vasculitis causing lesions of the skin and mucous membranes, with larger hemorrhagic and edematous damage in muscles and subcutaneous tissues.
What was the author’s experience using TP for purpura hemorrhagica?
TP was used in two severe cases unresponsive to glucocorticoids, with TP helping remove antibody-antigen complexes until immunosuppressive therapy became effective.
What conditions can lead to hypertriglyceridemia in equids?
Secondary to primary systemic diseases such as septicemia, colitis, esophageal obstruction, gastric impaction or rupture, fecalith, excessive parasitism, and pituitary adenoma, more frequent in miniature horses and donkeys.
