Plasmapheresis

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Shelly
Posts: 3
Joined: Wed May 05, 2004 11:01 pm

Plasmapheresis

Post by Shelly »

My 13 year old son was just diagnosed with MPGN. We are unsure of which type at this point. His Dr. sent his complement levels to a specialist in Denver. We are in PA. We have been struggling to find a diagnoses since Nov. That is when he first got sick.

The Dr. wants to do a procdure called plasmapheresis. I just wonder if any of you have any insight on this procedure. Your comments would be appreciated.

Shelly
JMan
Posts: 3471
Joined: Fri Apr 23, 2004 10:21 am
Location: Lives in a slightly weird bit of Shropshire called Telford!

Post by JMan »

Plasmapheresis is basically a 'screening' of filtering of the blood where red cells are returned and some elements are selectivley filtered out.

Simply put: The selective removal of certain proteins or antibodies.

Its sometimes known losely, as plasma exchange as the plasma is exchanged for a replacement that contains no antibodies.

Its actually a rather boring process and although the machinery can look a little fearsome it shouldn't be in anyway uncomfortable. At least not as I remember it ...

JMan
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jooms
Posts: 97
Joined: Sun Oct 24, 2004 4:22 pm
Location: Inverness, Scotland

plasmaphoresis

Post by jooms »

http://archives.cnn.com/2002/HEALTH/05/ ... index.html
is an easy to understand article although 2 years old. It did seem to promise that more transplants would be possible because it eliminated the requirement of matching tissue types.

Use key words Kidney Transplant & Plasmaphoresis on your search engine to get numerous other articles about the procedure and science involved.

Does anyone have any statistics or references about the present status of this procedure? (transplant success rates, what % of transplants involve this procedure, what hospitals do it).
Hal
Posts: 617
Joined: Wed Apr 21, 2004 9:56 am
Location: Liverpool, UK

Post by Hal »

Hi,

Jooms - I don't have the statistics you are looking for but I was at the National Kidney Federation conference a few weeks ago and a consultant named Dr Rob Higgins from a hospital in Conventry gave a talk on the subject.

Most UK health authorities are refusing to pay for the treatment and I think only Coventry has done more than 2 of these transplants (a few other UK units have done 1 each). He said the transplants are more stressful on the patient due to all the plasmapherisis sessions before and after the transplant, and the success rate is 90% (I presume this is a figure for 1 year after transplant).

The transcript of the lecture (and all the others at the conference) is not yet on the web site, but I presume it will be eventually here: http://www.kidney.org.uk/main/conference-index.html

Hal.
jooms
Posts: 97
Joined: Sun Oct 24, 2004 4:22 pm
Location: Inverness, Scotland

plasmaphoresis

Post by jooms »

Thanks Hal for that quick response. It confirms what my wife's renal consultant told her: the cost is the inhibiting factor.
Well there are ways that will reduce the numbers on the transplant waiting list but the political and economic arguments have to be won.

I suppose the plasmaphoresis equipment is available in hospitals to treat other conditions? Could the limiting factor(s) be availability of equipment, availability of trained staff, time?

Money should not be a limiting factor; this government seems to have plenty to spend on other things.

For every answer the questions multiply tenfold.
Mike
Posts: 1594
Joined: Fri Apr 23, 2004 2:47 pm
Location: Mansfield :o)

Post by Mike »

Hal wrote: Most UK health authorities are refusing to pay for the treatment and I think only Coventry has done more than 2 of these transplants (a few other UK units have done 1 each).
this really annoys me! How can they refuse this treatment on cost grounds? surely it is far more expensive to keep a person on dialysis compared to the cost to the NHS post tx?? From what I understand it costs in the region of £25000 a year for PD and up to £35000 on HD. The cost post tx is in the region of £6000!!

arghhh makes me mad :x :x

How much could this treatment cost? This is the one thing that could someday allow my brother to have a transplant.
jooms
Posts: 97
Joined: Sun Oct 24, 2004 4:22 pm
Location: Inverness, Scotland

plasmapheresis

Post by jooms »

It will come eventually, I suppose, but as always in UK it comes after every other country has it. In the meantime ..... ?
Cheryl in CT
Posts: 412
Joined: Wed Apr 21, 2004 10:17 pm
Location: Connecticut, USA

plasmapheresis

Post by Cheryl in CT »

Quite a while back (probably on the old KPG Board), I posted a good deal of info about plasmapheresis. Since then, use of this treatment in renal patients seems to have increased quite a bit - here in the US, anyway.

In answer to Jooms' question, yes, the procedure IS used for many other things (again, at least here in the US), so ostensibly, there SHOULD be equipment already available for use by renal patients who might need the procedure, too.

Here's just a bit of info from the US side of things:

Today, plasmapheresis is widely accepted for the treatment of Muscular Dystrophy, myasthenia gravis (it is not a cure but is used to temporarily reduce the level of circulating antibodies), Multiple Myeloma (where it can relieve some symptoms, though it does not kill the myeloma cells), Lambert-Eaton syndrome, Guillain-Barré syndrome (where it limits some of the side-effects of the destruction of the myelin of the peripheral nerves), and chronic demyelinating polyneuropathy (closely related to Guillain-Barré syndrome).

Its effectiveness in other conditions, such as polymyositis, dermatomyositis, and multiple sclerosis is not as well established. It is not clear whether plasmapheresis is of benefit in the short- or long-term treatment of MS, and its use in MS remains controversial.. Studies show that it may contribute to recovery from acute attacks in people with MS or other inflammatory demyelinating diseases who have not responded to standard steroid treatment.

A plasmapheresis treatment takes several hours and can be done on an outpatient basis. It can be uncomfortable but is normally not painful. The number of treatments needed varies greatly depending on the particular disease and the person's general condition. An average course of plasma exchanges is six to 10 treatments over two to 10 weeks. In some centers, treatments are performed once a week, while in others, more than one weekly treatment is done.

Plasmapheresis is performed at many major medical centers across the country, and a number of health insurance plans DO cover the procedure. Aetna, for instance, will cover plasmapheresis treatments for 23 different conditions/circumstances, including:

Renal transplantation from live donor with ABO incompatibility or positive cross-match, where a suitable non-reactive live or cadaveric donor is unavailable.

Solid organ transplant from donor with positive cross-match, where a suitable nonreactive donor is unavailable.

******

As I see it, the fact that some insurance companies WILL cover the procedure here in the US is rather telling, as much of what is or isn't done in the way of medical treatment here depends on whether or not one's insurance will cover it. (Just for the record, Aetna is a major insurance carrier here, and smaller insurance companies do tend to follow the example of the larger companies like Aenta in making their decisions about what will or will not be covered under their policies. This indicates that other insurance companies that may NOT have covered plasmapheresis treatments before will be doing so soon.)

Hope this info about plasmapheresis in the US adds a bit to the discussion.

all the best,
Cheryl
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