Plasma Exchange for Antiphospholipid Syndrome

NYU Langone doctors may recommend a procedure called plasmapheresis, also known as plasma exchange, to treat people with more severe symptoms of antiphospholipid syndrome. The blood has many components—including red and white blood cells, platelets, and plasma. Plasma is the fluid portion of the blood in which blood cells and platelets are suspended.

In people with antiphospholipid syndrome, the body makes antibodies that mistakenly attack phospholipids, which are a type of fat found in all cells and their membranes, including blood cells and the lining of blood vessels. Phospholipids are needed for blood clotting, or coagulation. When antibodies attack phospholipids, cells are damaged, causing blood clots to form in the arteries and veins. This can lead to blood vessel damage or stroke.

During a plasma exchange, you are attached to a special machine that removes some of the blood, eliminates the antibodies in the plasma that are causing the blood clots, and then returns the “cleaned” plasma and blood back into the body.

Doctors usually perform plasma exchange daily, on an outpatient basis, for a few weeks. During this time, your doctor may prescribe steroids and immunosuppressant medications to prevent the production of additional antibodies. People often continue using these medications for several months after plasma exchange has been completed.

Plasma exchange can temporarily remove the antiphospholipid antibodies that are causing symptoms, but its effects do not last more than a few months. Plasma exchange is typically not repeated, because other medications should control most symptoms when they start working.