This information is written especially for patients like yourself who may be exposed to plasma exchange as a treatment option. The subject of plasma exchange has reviewed in the Winter 2004 issue of The Communicator. This particular issue of The Communicator will review what was previously stated plus summarize a few references that discuss plasma exchange treatments for GBS and CIDP patients.
Use this information to help set a framework of assisting you with your discussions with your medical providers to help you understand this safe, simple, and routine procedure and what it will involve.
Your medial provider will make the appropriate treatment decisions for you.

Q. What Is Plasma Exchange?
Plasma Exchange is a patient procedure involving the separation and removal of the plasma from the blood in order to remove a disease substance circulating in the plasma. The red blood cells, white blood cells, and platelets are returned to the patient, along with a prescribed replacement fluid. Simply stated, the ''old plasma'' is removed and replaced by the ''new plasma.'' In other words, a PLASMA EXCHANGE took place.

Q. Will the procedure cause any pain and how long dies it take?
The initial insertion of the needles may cause some discomfort. The needles have to remain in place during the procedure (about two to four hours). Keeping the arms in one position and staying relatively still may be uncomfortable. The procedure time varies from patient to patient and with the type of blood cell separator utilized. The blood cell separators usually perform a plasma exchange in approximately two hours.

Q. Is Plasma Exchange a safe medical procedure?
Approximately 300,000 plasma exchange procedures are performed worldwide each year with few problems.

Q. Are there any reactions or lasting side ejects?
Some patients feel tired after a plasma exchange procedure and require rest. Side effects during the procedure might include feeling dizzy, light-headed, nauseated, and cold. Some patients may feel tingling in the fingers and around the mouth. It is extremely important for patients to notify the medical staff immediately if they feel these symptoms or feel uncomfortable. The medical staff can slow down or stopple procedure for a short time before deciding whether to continue.

Q. How often do Plasma Exchanges need to be performed?
The number of plasma exchanges varies, according to the disease treated and patient response. The physician monitors the clinical response and determines the necessary number and frequency of plasma exchanges to be performed.

Q. Can patients catch a disease from the supplies being used?
No. The blood tubing set and needles are sterile, used only one time, and then discarded. Anticoagulant, normal saline and albumin replacement fluid are also sterile solutions. There is some risk of disease transmission when fresh frozen plasma is used as a replacement fluid.

Brief Review of Literature
Treatments, such as plasmapheresis or intravenous immunoglobulin (IVIG), are frequently used in treating GBS and CIDP patients. The decision to use either therapy can depend on your medical professional who will determine treatment depending on severity of the disease, rate of progression, and length of time between the first symptom and presentation.

Your medial provider will make to appropriate treatment decisions for you.
Below please find a few publications available that discuss plasmapheresis and treatment of GBS and CIDP patients. Please discuss other publication options with your medical provider or our foundation. The National Institute of Neurological Disorders and Stroke website at: http://www.ninds.nih.gov/disorders/ebs/gbs.htm
provides additional literature that is available to the public. Please note that the terms TPE (Therapeutic Plasma Exchange), plasmapheresis and plasma ex-change will be used interchangeably in this article.