Short-term and Long-term Effects of Plasmapheresis on Serum Proteins and Immunoglobulins

In order to evaluate the short-term and long-term effects of plasmaapheresis on serum proteins and immunoglobulins, the levels of alpha1, alpha2, beta, and gamma globulins, and IgG, IgA, and IgM were measured and statistically evaluated in 41 active plasmapheresis donors donating 500 to 1,000 ml of plasma weekly for up to three years. During the initial four months of plasmapheresis, the percentage of alpha1 and alpha2 globulins manifested a statistically significant rise and the IgG, IgA, and IgM concentrations declined. By the end of ten months, only the IgM continued to be depressed. Although the concentration of IgM continued to show a statistically significant decline for three years, it remained well within the normal range of values for our laboratory. Although no statistically significant difference existed between the baseline value of albumin and the level reached at the end of the third year, a gradual rise was followed by a decline in this interval. Most of the statistically significant alterations of serum protein and immunoglobulins occurring in plasmapheresis donors are seen in the initial six months of plasmapheresis. A falling serum protein in this time period is most likely an indication of declining immunoglobulins. It is feasible and appropriate to measure the donor's total serum protein at the time of each plasmapheresis. Any untoward reduction in this value necessitates quantification of the serum immunoglobulins. Routine measurement of the immunoglobulins in the face of normal total serum protein can be performed on a less frequent basis as is presently recommended by accrediting agencies, although this study should be performed more often during the first six months of a serial plasmapheresis program.