Apheresis Service
Patient Guide to Plasma Exchange
(PEX) at University College London
Hospital
Why do I need a plasma exchange?
Your doctor has decided that due to your clinical condition, you need to have a plasma
exchange. This is because you have a condition where we have to remove antibodies or
replace deficient enzymes.
What is plasma?
Plasma is the fluid part of your blood that holds all your blood cells, antibodies, nutrients,
clotting factors and chemicals required for your body to function. It is a yellow colour.
What happens during a plasma exchange?
Your blood is taken out of a large vein in your arm into a machine called a cell separator.
The blood is spun very quickly so that the different parts of the blood separate into layers.
The separated blood cells are returned to you with donated plasma. Your own plasma will
travel up into a collect bag. Only about 180mls of blood will be outside your body at any
one time. The machine does require your blood to enter the machine quite quickly.
However, you will not feel it and the procedure does not normally make you feel unwell.
On admission due to your clinical condition, you may need a large line called a Vascath to
be inserted into your groin or neck. This is to facilitate the PEX. Experienced medical staff
will insert the Vascath either in the Interventional Radiology Department or in theatre.
Depending on your clinical condition, the PEX will either take place in your room or in the
Apheresis bay in day ward in the Cancer Centre. At the weekend and out of hours all PEX
procedures will be done in your room.
How long will it take?
The PEX usually takes between 3-5 hours.
Who will perform the plasma exchange?
Your PEX will be performed by a specially trained Apheresis nurse. UCLH has a very
experienced team of Apheresis nurses, who aim to give excellent care.
What happens after the procedure?
We ask that you rest in the bed for at least 20 minutes post completion of the PEX. We
strongly advise that you take this advice seriously as we do not want you to have a fainting
attack as a result of getting up from the bed too quickly. A porter and a qualified nurse will
escort you back to your in-patient bed after this time.
We will also monitor your temperature, blood pressure, pulse and oxygen levels.
Are there any side effects?
Yes, there are two main side effects.
Your blood would normally clot when leaving the body. To prevent this we use a blood
thinner or anticoagulant called ACDA. The ACDA binds with your calcium. Calcium is
essential in the blood clotting process. Some people are very sensitive to the ACDA and
their calcium drops very quickly. This can make you fee like you have an itching or tingling
nose, face, hands or body similar to pins and needles. Some people feel a vibration in their
chest. Do not worry as this is all easily resolved; just tell any of the nurses and we will give
you some calcium tablets to chew. If the symptoms persist you will need some intravenous
calcium into the return line. It is important that you do tell us if the symptoms do not resolve
or if they worsen.
The other possible side effect is a reaction to the replacement fluid. Even though we use
the very safest possible products at UCLH, there is always the possibility that your body will
react to a donated product. We will have the medication to resolve this and if it happens it
will probably not stop the procedure.
Discharge Home (if you are an out-patient)
Most people feel tired after the procedure. Even though you have been lying down your
body has gone through a lot. Please get up slowly after the procedure. It is ideal that you
have someone to take you home. Once you are at home, take it easy. If you have any
bleeding from the area where the line was inserted, you feel unwell or are worried about
anything please feel free to contact the Apheresis team (Mon-Fri 0800-1800): 0203
4478955
Overnight or at weekends contact the nursing team on the out of hours (urgent medical
advice) number: 07852 220900.
Contact Names / Numbers
TTP Consultant Lead: Dr Marie Scully
TTP Consultant: Dr John- Paul Westwood
TTP Clinical Nurse Specialist: Siobhan Mc Guckin
Mobile: 07908 175363
Approved By: Dr Marie Scully, Dr JP Westwood and Siobhan Mc Guckin