with Plasma Exchange and IVIG
What is desensitization?
Desensitization removes antibodies from the blood. Antibodies are proteins that are produced by
white blood cells to help the body fight infection. The making of antibodies is the body’s first
line of defense in the immune process. These antibodies work hard to protect our bodies and
keep us healthy. But, these same antibodies are bad for someone with a kidney transplant
because they can attack or destroy a transplant kidney. Antibodies are created during a prior
transplant, blood transfusion, or pregnancy. The process to remove antibodies is called
plasmapheresis. It is a process similar to hemodialysis, but will not replace your regular dialysis.
In the desensitization process, you will need 2 – 6 plasmapheresis treatment before your
transplant. You will also have these treatments after your transplant.
What is plasma exchange?
Plasma exchange is a process that removes the plasma and replaces it with healthy plasma. This
process is also called pheresis.
Why do I need a plasma exchange?
Plasma, the fluid within your blood, has proteins in it. In certain diseases, these substances
(autoantibodies) attack healthy cells. By doing a plasma exchange, we can remove some of the
autoantibodies. This treatment may make it possible for you to have your transplant.
How is plasma exchange done?
During plasma exchange, blood is drawn from your arm and passed through a small tube
(catheter). You may also need a catheter placed in a large vein in your neck or leg. The blood
flows from the tube into a bag that is placed in a special machine that spins the blood
(centrifuge). As the blood spins, it splits into plasma and blood cells (red cells, white cells, and
platelets). The plasma is light and rises to the top of the bag. The plasma layer is then removed.
The rest of the blood along with a plasma replacement is returned to your body through a small
tube to your other arm. Only about one cup of blood is removed from your body at any given
What is used to replace the plasma?
The plasma that is removed is replaced by:
Albumin – a human blood product that has been screened and heat-treated to prevent
disease from being transmitted. Side effects are rare, but may include nausea, fever,
chills, itching, low blood pressure, or flushing.
Saline – a salt water solution.
Fresh frozen plasma – from healthy plasma given by blood donors and has been
screened for viruses. Side effects may include itching, hives, chills, fever, and skin
flushing. Rare side effects are labored breathing, low blood pressure, and allergic
reaction. Be sure to tell your doctor or nurses if you notice any of these side effects.
How will I feel during the exchange?
Most people feel well during the exchange. Some have felt dizzy or light-headed. Slowing the
rate of the exchange or lowering your head can help relieve these symptoms. Some people have
numbness in the lips, and tingling in the hands and fingers. Chewing Tums® or drinking milk
can help. Others are slightly sick to their stomach (nauseated). These symptoms often go away
after the exchange is done. It will help if you eat something before the treatment.
You may receive a medicine called Immune globulin (IVIG). It is given through an IV in your
arm or a catheter in your neck. This medicine helps prevent the return of the antibodies or a
rebound. The entire treatment takes 5 – 6 hours.
Caring for yourself after plasma exchange
Most people feel tired. Plan on little or no activity for the next few hours.
If you are dizzy, lie down and raise your feet higher than your head.
For the next few hours, leave your bandages on and keep them dry.
Do not do any heavy lifting or exercise.
Since blood thinners are added to your blood to prevent clots from forming, you will be
at risk for bruising and bleeding during the next 24 hours. Avoid contact sports and
activities that would put you at greater risk.
If you have any redness or pain where the needle was placed, call the UWHC Infusion
Center at 608-263-8369.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 3/2016. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5790.