Plasmapheresis - indications, contraindications, or what color the blood is. Plasmapheresis - what is this procedure and when is it necessary? Is it possible to eat before plasmapheresis?

The word “plasmapheresis” is formed from two words: plasma - plasma, the liquid part of organic tissues, and aheresis - removal, excretion. That is, the essence of the procedure is to remove excess plasma with unnecessary substances that accumulate in it and, along with the bloodstream, are carried throughout the body.

Plasmapheresis should be prescribed strictly after consultation with a specialist. We ask you not to self-medicate, but to make an appointment for initial examination and the purpose of the procedure - plasmapheresis! Today medicine has stepped forward, and there are many ways to purify blood, but only a specialist is able to assess the situation and prescribe the most effective and safe procedure.

Blood purification: plasmapheresis
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Plasmapheresis in Moscow: how it works and in what cases plasmapheresis is prescribed

Technically, the process of blood purification by plasmapheresis looks like as follows: part of the blood is taken from the patient, in special equipment it is separated into cells and the actual liquid, plasma, then the plasma is removed, the cells are returned to the bloodstream, and instead of the removed liquid, replacement saline solutions are injected into the vein.

After cleansing the blood with plasmapheresis, relief and improvement in the person’s condition occurs, since toxic substances are eliminated from the body.

Plasmapheresis cannot and cannot be carried out in one procedure, so several days are allocated for the entire cleaning procedure.
It is impossible to remove individual elements and compounds from the bloodstream in this way, but in general, plasmapheresis can significantly alleviate the patient’s condition.

How to cleanse blood: what is removed from the bloodstream using plasmapheresis blood cleansing procedure

Remains of bile, which the body could not utilize, and it entered back into the body.
Toxins and breakdown products toxic substances.
Residues of drugs.
Decay products of pathological and unhealthy cells.

Plasmapheresis: unique methods of blood purification

Prices for plasmapheresis depend on the type of technique. There are membrane and cascade plasmapheresis. The membrane procedure lasts approximately an hour, the cascade procedure lasts 2-3 hours. During blood purification using the membrane method, blood is removed and purified using membrane plasma filters. In the membranes, the blood is divided into blood cells and plasma, which is removed along with the toxins it contains.

After blood purification by plasmapheresis, the blood will take on a rich, bright red hue, and the plasma will appear cloudy yellow rather than clear, as it should be. Instead of the withdrawn portion of plasma, saline solution is infused into the bloodstream.

Cascade plasmapheresis

Double plasma filtration, or cascade method, is a more expensive and longer procedure. The price of blood purification using plasmapheresis will depend on the number of procedures and the severity of the patient’s condition. The dual method uses two filters. The first makes it possible to obtain plasma and separate blood cells from it, and the second filter divides the plasma into fractions. Protein and electrolytes are returned to the bloodstream, and high-molecular plasma elements, toxins, and viruses remain on the filter.

Blood plasmapheresis - a double purification method solves two problems at once:

Cleanses the blood of toxins and breakdown products biological substances in the body and viruses.
Increases microcirculation in small blood vessels, improves tissue nutrition, they are saturated with oxygen, improve rheological properties blood.

Blood plasmapheresis - this method allows you to effectively clean the blood and not spend money on restoring lipid levels in the plasma and instilling saline solution with nutrients.

Plasmapheresis: how to cleanse the blood of drugs and alcohol

By contacting our clinic, you can make an appointment with a specialist who will determine the need for plasmapheresis. The procedure is indicated as a preventive measure for many people, but it has both indications and contraindications.

Plasmapheresis: reviews of use

Plasmapheresis, according to reviews, is especially indicated for people who abuse alcohol or drugs. In addition to the fact that remnants of toxic substances accumulate in the blood, cholesterol appears in the vessels more quickly, clots of blood cells remain that form microthrombi, and remnants of bile that are not excreted due to a malfunction of the gastrointestinal tract and liver dysfunction.
Alcoholics binge drink because toxic substance I don’t have time to be eliminated from the body due to disrupted biochemical processes. Plasmapheresis is indicated for them to reduce acute intoxication and withdrawal from binge drinking.

Plasmapheresis: contraindications

Before clearing the blood of drugs or alcohol, contraindications to plasmapheresis are assessed.
These restrictions may include:

Anemia.
Chronic diseases in the stage of decompensation. In such cases, plasmapheresis can be prescribed, but will not solve the problem.
Acute diseases and infectious diseases, purulent-inflammatory diseases.
Low clotting blood and insufficiency of albumin bodies in the blood.
Cancerous tumors accompanied by bleeding.
Open ulcers, gangrene and so on.

In any case, only a specialist can decide whether plasmapheresis is necessary.

Blood purification: laser blood purification

In addition to plasmapheresis, another modern method. If you are thinking about how to clean your blood faster and better, you can use laser blood purification.

The procedure is called ILBI - intravenous laser irradiation blood. The procedure has virtually no contraindications, but is cutting-edge, requires highly qualified specialists and the presence of expensive equipment in the clinic, and therefore costs more than plasmapheresis.

Cleaning is carried out under the supervision of a doctor; as a rule, laser blood cleansing requires 5-10 sessions.

Laser blood purification: ILBI

A disposable diode needle is launched into the vein, which emits special radiation. The point where the needle is in the hand turns bright red. Irradiation has a detrimental effect on viruses, bacteria, and toxins in the blood.
Laser therapy blood cleansing prevents the formation of blood clots, affects the normalization of blood pressure, enhances the body's immune response, and improves the production of blood cells.

With the help of laser cleaning, you can cleanse the blood of alcohol and drugs much better than any other method, however, the indications for the procedure should only be determined by the attending physician

You can clean your blood here:

fast and inexpensive

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Should I do plasmapheresis or clean my blood at home?

Many people are looking for inexpensive ways to purify blood at home. This is only possible if you regularly follow a diet and eat certain products. If a person constantly uses alcohol or drugs, then he will not be able to choose a method of how to quickly cleanse the blood without medical intervention, because such a method does not exist.

However good help For any person it will be possible to eat:

Beetroot.
Oats.
Garlic.
Potato broth.
A decoction of nettle and milk thistle herbs (caution, herbs should not be taken orally in case of thrombosis and increased coagulability).

How to clean blood at home? Doctors usually suggest installing an IV during home detoxification of the body.

It is problematic to fully clean blood with a dropper at home: it is impossible to bring so much equipment into the house, especially unnoticed.

Therefore, the answer to how to purify blood at home using modern procedures, remains unanswered for now. Perhaps in the near future mobile micro devices will be invented, but for now the best solution The patient will be admitted to a hospital where they will undergo blood cleansing and plasmapheresis. According to reviews, any drug treatment for alcoholism after installing a drip to cleanse the blood goes much faster.

How to quickly and effectively clean blood!

If you are concerned about whether it is possible to clean the blood quickly and effectively, at the stage of alcoholism or drug addiction that a person is at, just call our clinic and ask the specialist on duty.

He will tell you how to cleanse your blood of toxins and recommend suitable method and will sign you up for a plasmapheresis or laser blood purification procedure.

The answer to the question of where to clean the blood is in the list of addresses of our clinics and rehabilitation centers. Choose the one that is most convenient for you or call us. We will recommend the closest center or hospital clinic and provide prices for all procedures. The call is free, the treatment is anonymous!

Discrete (centrifugal) plasmapheresis– a method of plasma purification by centrifugation. Used to reduce plasma concentrations of immune complexes, antibodies, antigens, toxins, hormones, lipids or proteins. The disadvantage of plasmapheresis is the lack of selectivity and the need to replace removed useful substances protein preparations and other solutions. Blood is drawn from peripheral vein. The blood is then placed in a centrifuge and separated into red blood cells and plasma. The plasma is removed, and the red blood cell mass is administered to the patient along with plasma-substituting solutions. The procedure lasts 1.5-2 hours.

In the process of discrete plasmapheresis, along with the removed plasma, pathological and excess physiological products, which are pathogenetic factors in the maintenance of diseases and the development of complications, are removed from the body. Along with the return of blood cell mass, colloid and crystalloid solutions, donor plasma, and albumin are administered to the patient to prevent hypovolemia and hypoalbuminemia. Along with the detoxification effect, plasmapheresis provides immunocorrection and normalization of homeostasis.

The advantages of discrete plasmapheresis are its accessibility and the absence of the need for expensive equipment. In comparison with other extracorporeal hemocorrection technologies (hemosorption, plasmasorption, hemodialysis, hemofiltration), plasmapheresis has a lower cost and is accompanied by the least damage to blood cells. However, in terms of its physiology, discrete plasmapheresis is inferior.

The validity of plasmapheresis is determined by a transfusiologist. The minimum scope of examination before plasmapheresis includes clinical tests blood and urine, blood biochemistry, coagulogram.

Indications

The use of plasmapheresis in rheumatology is based on the reduction of inflammatory mediators, CEC, RF titer, immunoglobulins, seromucoid, fibrinogen, autoantibodies and other factors supporting pathological processes. When rheumatic diseases are resistant to pharmacotherapy, plasmapheresis becomes the treatment of choice. In rheumatology, plasmapheresis is included in the treatment of thromboangiitis obliterans, periarteritis nodosa, gout, rheumatoid arthritis, systemic lupus erythematosus, dermatomyositis, scleroderma, systemic vasculitis, etc.

In allergology, plasmapheresis is used for bronchial asthma, hay fever, Quincke's edema, and acute urticaria.

For dermatological diseases, plasmapheresis is justified in the case of neurodermatitis, eczema, psoriasis, atopic dermatitis, acne, furunculosis.

In neurological practice, plasmapheresis is indicated for myasthenia gravis, multiple sclerosis, inflammatory polyneuropathy, and chronic fatigue syndrome.

Plasmapheresis procedures are widely used in cardiology for non-drug correction of coronary artery disease, hypertension, atherosclerosis of the lower extremities, hypercholesterolemia, high viscosity blood.

The grounds for plasmapheresis in hepatology are hepatitis, cirrhosis, hepatosis, and non-infectious jaundice.

Obstetric and gynecological indications for plasmapheresis include STIs (ureaplasmosis, chlamydia, cytomegalovirus infection, etc.), infertility, APS syndrome, Rh-conflict pregnancy, gestosis, menopausal syndrome, inflammation of the appendages.

The range of contraindications for plasmapheresis includes terminal states; allergies to plasma, protein drugs or anticoagulants; bleeding, oncology, acute infectious and purulent diseases. In case of unstable hemodynamics (BP tachycardia, BCC deficiency, anemia (

Carrying out the procedure

Before the start of the plasmapheresis session, the main hemodynamic parameters are monitored. After venipuncture, heparin is administered and antihistamines, then the blood is exfused into a 500 ml hemacon (a disposable sterile plastic container made of polymer material containing a preservative).

The hemacon is placed in a centrifuge, where after processing the cell mass and plasma are separated. The plasma is removed from the bag using a plasma extractor, and the cell mass is “washed” with saline and returned dropwise to the patient’s bloodstream. At the same time, during plasmapheresis, an adequate infusion of plasma-substituting solutions is carried out.

During one session of therapeutic plasmapheresis, it is recommended to remove no more than a quarter of the volume of plasma circulating in the bloodstream (on average 600-800 ml). Blood exfusion and reinfusion are usually performed three times during one plasmapheresis procedure. A discrete plasmapheresis session lasts about 2.5-3 hours.

After a plasmapheresis session, there is a noticeable decrease in the concentration of pathological substrates in the blood, but after certain time their new release occurs from the interstitium, bones, intercellular fluid, internal organs etc. Therefore, for complete detoxification of the blood, a cycle of successive plasmapheresis procedures is required, which is determined individually (from 2-3 to 10-12).

The price for discrete plasmapheresis will depend on the volume of plasma removed simultaneously, and the cost of a course of plasmapheresis will depend on the number of prescribed sessions.

Complications

If any adverse reactions the plasmapheresis procedure should be stopped and measures taken to relieve the developed condition.

During plasmapheresis, there may be allergic reactions for the administration of transfusion media or donor plasma. These reactions are manifested by chills, hyperthermia, hemodynamic disturbances, autonomic reactions, rash, and less commonly, anaphylaxis. In this case, the administration of antihistamines, sedatives, and corticosteroids is indicated.

With the simultaneous removal of a significant volume of blood volume, hypovolemia and hypotension develop, which are corrected by active compensation of blood loss.

Given the existing stress erosions and ulcers of the gastrointestinal tract during plasmapheresis, the risk of bleeding cannot be excluded. With the development of hemorrhagic syndrome, heparin is neutralized with protamine sulfate solution and hemostatic therapy is performed.

The risk of bacteremia in connection with plasmapheresis is due to the introduction of bacteria into the bloodstream when the sterility of the procedure is violated.

With citrate intoxication, as a reaction to the anticoagulant used during plasmapheresis, numbness and convulsive syndrome, which requires the introduction of a solution of calcium chloride.

Prices for discrete plasmapheresis procedures in Moscow clinics can be seen on this page.

IN modern world The human body is increasingly forced to come into contact with exhaust gases, tobacco smoke, alcohol-containing drinks, medicines, pesticides, etc. As they accumulate, harmful substances provoke the appearance of various pathologies. Today one of the most effective ways Plasmapheresis treatment is used to cleanse the body of toxic products. By using this method Plasma containing all harmful substances is removed from the patient’s blood.

Plasmapheresis is blood purification, as a result of which biological material outside the human body is divided into “good” and “bad”. The first one returns back to the body, the second one is disposed of.

Initially, this technique was used to process donor blood. But today the plasmapheresis procedure is recognized as one of the most effective techniques healing the body. In addition, the method is purposefully used to combat certain diseases.

Species

Blood plasmapheresis is medical procedure implying a fence venous blood patient and its subsequent division into components. After this, the purified biomaterial is injected back into him. As for plasma donation, only shaped elements.

The procedure can be carried out either with or without the use of special equipment.

The following non-hardware methods exist:

Gravitational. Its principle is based on the action of gravity. The formed elements of blood, which have greater weight, sink to the bottom of the container, and they are introduced back to the person. In view of low rate effectiveness in practice, this method is used extremely rarely.
Filtration. The essence of the method is the same as the gravitational one. The difference is that the process uses special filters, thanks to which the separation into components occurs in a shorter period of time and with better quality.

Today, the above methods are losing relevance, giving way to those carried out using equipment.

In practice, many plasmapheresis devices are used, differing in functionality. However, there are only two ways to separate blood into its components.

Based on this, there are 2 types of hardware plasmapheresis:

Centrifugal. A method that allows you to get a “good” fraction for the maximum short time. Thanks to this, the integrity of cellular structures is not compromised and the properties of other components are preserved. The essence of the procedure: blood in a special container is placed in a centrifuge equipped with modern software, and is separated at high speed for several minutes. Then the container is removed and the plasma contaminated with harmful substances is removed from it.
Membrane. The essence of the method: the patient's blood is distilled through special filters using pumps built into the equipment. This method also has high speed. In addition, the membrane plasmapheresis procedure allows you to process a large volume of blood along with the highest possible degree of purification. In most cases, the method is used to treat various pathologies. With the help of membrane plasmapheresis, improvements in the patient’s condition can be achieved even with severe diseases. In some cases, the procedure is more effective than drug therapy.

Indications

Plasmapheresis is not a preventive measure that anyone can resort to. The procedure is carried out only on the recommendation of a doctor. As a rule, it serves additional method treatment in cases where the main treatment regimen does not bring positive results.

Indications for plasmapheresis include pathologies of most organs and systems:

damage to the heart muscle;
high levels of “bad” cholesterol in the blood;
complications after a heart attack;
rheumatism;
atherosclerosis;
myocarditis of viral origin;
pulmonary vascular diseases;
bronchial asthma;
alveolitis;
pneumonia;
Crohn's disease;
damage to the wall of the large intestine, accompanied by the appearance of ulcers;
liver pathologies;
inflammation of the oral mucosa;
diabetes mellitus, including its disorders;
dermatological problems ( allergic rashes, psoriasis, urticaria, etc.);
arthritis;
pathologies of the visual system;
kidney failure;
seasonal diseases ( high sensitivity to cold, heat, etc.);
multiple sclerosis;
oncological diseases;
thromboembolism;
hepatitis;
pathologies of the reproductive system;
Rh conflict during gestation;
acne;
alcoholism;
drug use;
poisoning with poisons and drugs.

This list can be expanded during an individual consultation with a specialist. To date, the procedure has been successfully used in the fight against approximately two hundred diseases. Judging by medical reviews, plasmapheresis in combination with drug treatment allows for significant improvements.

Contraindications

The procedure has a number of limitations. The decision on the need to prescribe it is made by the attending physician after a thorough examination.

Absolute contraindications to plasmapheresis are:

extreme brain damage;
bleeding.

There are also restrictions that can be ignored at the discretion of the doctor. Relative contraindications to plasmapheresis are:

Tendency to bleed. The procedure involves the use of drugs that reduce clotting. This is important to ensure that the installed catheter does not become clogged with blood clots. This increases the risk of bleeding.
Ulcerative lesions of organs gastrointestinal tract. After plasmapheresis, the risk of bleeding also increases.
Arrhythmia, decreased blood pressure. Despite the fact that the patient is deprived of a certain volume of blood for a short time, the functioning of the cardiovascular system may deteriorate. During the procedure, blood pressure decreases and arrhythmia increases, which can provoke the emergence of health-hazardous conditions.
Lack of protein in the blood. These substances are vital for ensuring normal operation all organs and systems human body. After the blood purification procedure, a certain amount is lost, which increases the risk of various pathologies.
Infectious diseases in acute stage. This limitation is explained by the fact that cardiovascular system during this period experiences increased stress.
Menstruation. Carrying out the procedure during menstruation can significantly worsen general condition women.

Positive Action

Reviews of plasmapheresis from most people are extremely positive. Patients note improved well-being, increased strength, and increased performance.

Benefits of plasmapheresis:

are strengthening protective forces body;
the level of “bad” cholesterol in the blood decreases;
metabolic processes are accelerated;
cells are better saturated with oxygen.

The benefits and harms of plasmapheresis are determined by the adequacy of the purpose of the procedure, as well as the correctness of its implementation. Compliance with all conditions reduces the likelihood of side effects.

The following conditions may occur immediately after plasmapheresis:

weakness;
dizziness;
blurred vision.

These reactions are normal and do not require medical care. To eliminate them, it is recommended to lie down for 15-20 minutes.

After plasmapheresis, the following complications may occur:

Allergic reaction. It can be caused by medications used to thin the blood. Manifested by chills, rashes, fever, rarely develops anaphylactic shock. In case of poisoning, the following are observed: numbness of various parts of the body, convulsions.
Bleeding. May be a consequence of an overdose of substances that reduce the coagulation rate. The risk also increases with existing peptic ulcers organs of the gastrointestinal tract.
Thrombosis. If, on the contrary, the dosage of the above-mentioned substances is insufficient, the catheter and the wall of the vessel in which it is installed may become clogged. blood clots. If a blood clot gets into the bloodstream, the likelihood of serious conditions will increase.
Sepsis, HIV infection. Currently, only sterile, disposable needles and instruments are used during the procedure, which reduces the risk of infection to zero. It is important to contact only medical institutions who have a license to practice transfusiology.

Preparation for plasmapheresis

Before the procedure, the patient mandatory must undergo examination. It includes:

General blood test. Important for identifying various pathologies at an early stage.
Coagulogram, assessment of coagulation rate. Allows you to detect a predisposition to bleeding or, conversely, thrombosis.
Wasserman reaction. Test that detects syphilis.
A test to determine blood glucose levels. Necessary to exclude or confirm the presence of diabetes mellitus.
Blood protein analysis. Reduced level of these substances is relative contraindication for plasmapheresis.
Blood pressure measurement. If there are large deviations from the norm in any direction, the procedure may be postponed.
ECG. Necessary for assessing the functioning of the cardiovascular system.

48 hours before plasmapheresis you need to:

Avoid drinking alcoholic beverages and coffee.
Drink at least 2 liters of bottled still water per day.
Stop taking medications that may cause complications. The doctor must be informed in advance about the medications used; he determines which ones you need to stop taking.

Immediately before the procedure, you need to empty your bladder, and smoking is prohibited 2 hours before.

How is it carried out?

The plasmapheresis algorithm includes the following steps:

The patient is placed on a special chair. For convenience, it can take both a sitting and lying position.
A catheter is inserted into the vein, through which blood begins to flow into a sterile bag. As a rule, the best option are the vessels located in the area of the elbow. If they are not visible in this area, the catheter is installed in the subclavian vein. Biomaterial is collected 1-3 times. This is due to the fact that approximately a third of the blood is cleansed in one session. On subsequent occasions from harmful substances cells are released. Due to this, cleansing is considered better and more effective. For one procedure, 350-500 ml of blood is enough.
The filled bag is placed in equipment where the liquid is separated connective tissue on plasma and formed elements. The cell mass, diluted with blood substitutes, is returned to the venous bed through an already installed catheter. If the centrifugal method of plasmapheresis is used, separation can occur automatically without the need for additional manipulations. In this case, 2 catheters are installed simultaneously for the patient. From one tube, the biomaterial enters in small portions into a centrifuge apparatus, where it undergoes separation. The plasma is immediately drained, and the formed elements are mixed with blood substitutes and injected back into the patient’s veins through a second catheter. Due to the need to purchase expensive equipment, centrifugal automatic plasmapheresis is used quite rarely in practice.
After completion of the procedure, the patient is recommended to remain under the supervision of a doctor for some time (about 30 minutes).

The duration of the session is on average 1-1.5 hours. Reviews of plasmapheresis, in addition to its effectiveness, emphasize that during the procedure there is not the slightest discomfort.

Price

The price of plasmapheresis is determined differently in each medical institution. However, the procedure is considered very expensive.

For example, in Moscow plasmapheresis is carried out in most multidisciplinary clinics. The advantage of private organizations is the availability of a flexible system of discounts for regular customers. The cost of plasmapheresis in Moscow averages 5-8 thousand rubles. In other cities the lower threshold is lower. For example, the average price of plasmapheresis in Khabarovsk is 3-7 thousand rubles.

, ). Depending on the purpose, there are 2 types of procedures:

Therapeutic plasmapheresis– consists of separating plasma from blood cells in order to remove plasma containing toxins, allergens, autoantibodies... In this case, the formed elements are returned back into the bloodstream, and the plasma is utilized. This procedure allows you to reduce the concentration of some toxic elements (poisons, toxins, allergens, antibodies...) in the human body. Thus, this is one of the types of detoxification therapy.
Donor plasmapheresis– also involves separation of plasma from blood, but the procedure is carried out healthy people(donors), and the resulting plasma is preserved for subsequent transfusion or the creation of blood products.

Types of plasmapheresis depending on the method of plasma separation:

Sedimentation - separation of plasma occurs due to sedimentation. At the same time, blood cells gradually precipitate.
Centrifugal - the separation process is accelerated due to the action of centrifugal force on the formed elements of the blood.
Filtration – special plasma filters are used.
Membrane - based on the use of special semi-permeable membranes that allow plasma to pass through, but not blood cells.
Cascade - in this case, the already obtained blood plasma is re-passed through a special filter, which allows only low-molecular-weight blood proteins (albumin) to pass through and retains high-molecular-weight ones (lipoproteins).

Indications for plasmapheresis:

exogenous intoxications:

food poisoning;
overdose medicines;
consequences of chemotherapy;

endogenous intoxications - serious illnesses, accompanied by severe intoxication of the body:

osteomyelitis;
heavy infectious processes;
paraneoplastic syndrome;

autoimmune diseases:

rheumatoid arthritis;
bronchial asthma;
multiple sclerosis;
Guillain Barre syndrome;

blood diseases:

multiple myeloma;
macroglobulinemia;
paraproteinemia;
thrombocytopenic purpura;
monoclonal gammopathy.

amyloidosis;
in combination with severe atherosclerosis;
donation

Contraindications to plasmapheresis:

Absolute:

continued bleeding;
blood clotting disorder.

Relative:

risk of bleeding, for example, peptic ulcer of the stomach and duodenum; if a decision is made about the need for plasmapheresis, the procedure is carried out without the use of heparin;
unstable hemodynamics;
hypoproteinemia;
acute infectious processes;
menstruation.

Myths and misconceptions

Many domestic commercial medical institutions often unreasonably prescribe plasmapheresis, telling patients fairy tales and fables about its miraculous properties. Here are some of them:

has a rejuvenating effect;
cleanses of toxins (no such toxins exist in the body and cannot exist);
can be used to prevent almost all diseases;
normalizes hormonal background;
normalize metabolism;
normalize immunity;
improves microcirculation in organs and tissues - this is true, but it is not associated with plasmapheresis, but with the action of heparin, which is used during the procedure;
+ everything that comes to mind for a doctor thirsty for profit or suffering from medical perversion.

It is important to understand that plasmapheresis “does only what it does” - it reduces the concentration of certain substances in the blood. It does not prevent their formation in the body, does not eliminate the cause, and in most cases is used only in complex therapy. Thus, its implementation is indicated only when there is an increase in the blood of one or another substance that negatively affects the body, and the risk of complications from the procedure does not exceed the risks associated with the underlying disease.