Hemapheresis is the process of selective collection of any blood component, with the use of automated equipment. In this process components of blood ie: RBC, WBC, plasma and platelets are removed from the patient ‘s body to achieve patient health and provide relief in symptoms. These diseases are not completely prevented but the symptoms and conditions are manageable. Let’s discuss Hemapheresis in detail about Hemapheresis.
In the process of hemapheresis there is a removal of whole blood from the body of the donor. It is the process by which one or more components are withdrawn from the blood and returned by transfusion of remaining blood to the donor. Hemapheresis is considered as a supportive treatment for auto-immune and blood disorders. In auto-immune disorders the body produces antibodies which attack its own immune system and create infection in the blood. Ayurveda produces some of the great herbs and therapies which are very effective in cleansing the blood, in which leech therapy is very important. Rakta shodhana and Rakta mokshana are the procedures that are involved in hemapheresis. The blood is alive, contains living cells and is the fluid of health, transporting disease fighting substances to the tissue and waste to kidneys. The components of blood ie. red blood cells and white blood cells are responsible for nourishment and cleansing the body, blood also carries the oxygen to all body parts. When the body grows, it faces toxins, environmental pathogens and contaminated food by which the blood gets infected which causes the blood disorders.
Process of Hemapheresis
In this process the blood is taken from the donor’s body and then blood is removed from the donor’s body through a needle. Removed blood is mixed with the anticoagulant and separated in separators which works on the centrifugation process. Where the desired component is separated and the blood is returned to the donor’s body results in the filtered plasma.
The components which are separated are
- Leukocytes (leukapheresis)
- Plasma (Plasmapheresis)
- Platelets (Plateletpheresis)
Leukapheresis: White blood cells (leukocytes) are removed from the patient’s body if the patient is suffering from a disease like thrombosis.
Plasma is the important component of the blood and contains antibodies and antigen- antibody complexes which may contribute to effects of autoimmune disorders. Plasma removal helps in reducing the circulating antibodies and immune complexes. In case a large amount of plasma is removed, the plasma from a healthy donor is given to the patient which is called plasma exchange.
Plateletpheresis: This is very rare like: Myeloproliferative disorders, platelet count can be very high. Removal of platelets is helpful in Platelet removal and can help to avoid complications of thrombosis and bleeding.
Indications of Hemapheresis
Indications of Hemapheresis are
- Sickle cell disease
- Liver transplantation
- Familial cholesterolemia
- Lung transplantation
- Wilson disease
- Hemolytic disease of foetus
- Inflammatory bowel disease
- Myasthenia gravis
- Kidney transplantation
- Aplastic anaemia
- Systemic amyloidosis
- Burn with circulatory shock
- Acute liver failure
- Dilated cardiomyopathy
- Multiple sclerosis
- ABO- Incompatible hematopoietic solid organ transplantation
- Chronic inflammatory demyelinating polyneuropathy
- Auto-immune hemolytic anaemia
- Age-related macular degeneration
- Amyotrophic lateral sclerosis
- Coagulation factor inhibitors
- ABO- Incompatible hematopoietic stem cell transplantation
Ayurvedic Overview of Hemaphereis
In Ayurveda blood is known as rakta and a very important component of the human body, disorders of blood cause prolonged and chronic disease. Acharya Shusruta who is known as father of surgery considered Rakta as a fourth dosha, mainly three doshas are the base of the body ie. Vata, Pitta and Kapha but Acharya Shusruta has also described Rakta as a fourth dosha. In Ayurvedic perceptive when doshas contaminates the blood it results in blood disorders which in ayurveda is called as Rakta Pradosaja Vikara, and there are many rakta-pradosja vikara and their modern co-relation which are as follows
- Pleeha (Splenomegaly)
- Vidhradi (Abscess)
- Pama (Scabies)
- Kamala (Jaundice)
- Neelika (Hyperpigmentation)
- Arsha (Piles)
- Asya paka (Stomatitis/ Mouth ulcers)
- Mashaka (Elevated moles)
- Shwitra (Leucoderma/vitiligo)
- Charamadala (Dermatitis)
- Kotha (Urticaria)
- Tilkalka ( Black Moles)
- Vyanga (Freckles)
- Visarpa (Herpes)
- Indralupta (Alopecia)
- Asru Dhara (Menorrhagia)
- Kushtha (Leprosy)
- Guda pak (Inflammation of anal canal)
- Raktapitta (Bleeding disorders)
- Vatashonit (Gout arthritis)
- Medhra paka (Inflammation of penis)
- Arbuda (Tumours)
- Piplu (Port wine mark)
- Gulma (Abdominal tumours)
Ayurveda Relation of Hemapheresis with Raktashodhana
Hemapheresis is related with Rakta Shodhana (purifying blood) and Rakta mokshana in Ayurveda and raktashodhana is the process which is used to purify the blood by using various herbs. There is also another process by which the vitiated Rakta is balanced which is known as Raktamokshna (bloodletting). Now we do not have to confuse rakta shodhana and rakta mokshana, both the processes are quite different. Purifying the blood through the herbs and natural remedies is called Rakta shodhana and where the toxins are very high and Rakta shodhna is not enough, in that case Rakta mokshana is used. Herbs which are used in Rakta shodhana are as follows
Effective Herbs to Purify the Blood
Guduchi (Tinospora Cordifolia)
Guduchi is very useful in the aggravation of Tridoshas (Vata, Pitta and Kapha) , has anti- inflammatory properties and gives relief from the pain. This herb plays a great role in conditions of worm infestation, gives relief in jaundice, and increases the blood cells. Guduchi is very effective in chronic fever, in skin disorders and also reduces the weakness.
Haridra (Curcuma Longa)
The herb pacifies the Tridoshas and purifies the blood and is useful in preparation of the Red Blood cells. Haridra contains antiprotozoal, antiseptic and anti-inflammatory properties and useful in anaemia, leprosy haemorrhage and diabetes etc.
Manjishtha (Rubia Cordifolia)
Manjishtha pacifies the vitiated rakta and contains properties like: anti-inflammatory, antipyretic and anti protozoal. The herb is very effective in leprosy and in wound healing. It purifies the blood completely and acts as a rasanya and also gives relief from stress. The herb is very effective in female reproduction, contains diabetic properties, boosts the stamina and removes the toxins.
Neem (Azadirachta Indica)
Neem contains various properties and is helpful in many problems, it mainly pacifies the Pitta dosha due to its soothing and cooling effects. This herb is used in healing of the wound, abscess, blood disorders, alopecia, itching and greying of the hairs.
Sariva (Hemidesmus Indicus)
Sariva is useful in pacifying all tridoshas, has anti-inflammatory properties and contains a cooling effect. Sariva acts as a rasayana and is diuretic, it increases sexual activity and also increases fertility. The herb contains blood cleansing properties and is helpful in conditions like: syphilis, elephantiasis and leprosy etc. This herb is very useful in digestive problems and also acts as a diuretic.
Rakta Mokshana Therapy
Acharya Sushruta has described raktamokshana as a type of panchkarma. Rakta mokshana is used when there is a presence of high toxins and rakata shodhana is not enough. Some of the natural sources (ie. Instrumental and non-instrumental) used in this therapy are
Siravedha and Pracchan (Vein puncturing)
Non- instrumental (Anu-shastra): Alabu (Pitcher gourd), Jaloka (Leech therapy) and Shrunga (Cow’s horn method)
This procedure is very useful in destroying the disease from the root. Venepuncture in Shalya tantra is considered as the half complete therapy for numerous diseases as blood is the pathogenic factor in most of the diseases.
Prachana (Blood Letting by Puncturing)
In this procedure torniquet is applied slightly above the affected area and multiple incisions are made by using the sharp instrument and avoiding the vital structures. The incisions are not made very deep, superficial, should not be done transversally and are made very quickly in the upward direction.
Alabu (Blood letting through pitcher guard)
The process is used in aggravated Kapha dosha and pacifies the aggravated Kapha dosha. In this procedure, small incisions are made on skin and after that the pitcher guard made hollow within, creating vacuum pressure by lighting the diya. Now the guard is kept at incised skin through blood is sucked by vacuum pressure, thus doing blood letting.
Jaloka (Leech Therapy)
This is the most important therapy in the raktamokshana and is a commonly followed procedure for blood letting. In aggravated Pitta vitiated rakta dosha this is very helpful as the leeches reside in the cold conditions. Jaloka is very useful in acne and skin disorders, the procedure is used in the patients who are scared from other bloodletting procedures.The saliva of leech contains the chemical Hirudin which is anticoagulant and prevents the blood from coagulation and inhibits the platelet aggregation and increase fluids and blood flow from the affected area. Leech only takes the blood which is vitiated and corrects microcirculation disorders. The therapeutic properties of this procedure are: it is immunostimulating, antioxidant, anti-inflammatory and atherosclerotic.
Types of Leech
There are mainly two types of leeches are considered ie. Poisonous and non- poisonous. Poisonous is called Savish and has 6 more types, non- poisonous is known as Nirvish contains 6 types. These types are described in (Sushruta Sutrasthana chapter/13 Sloka 11/12)
Poisonous (Savish Jaloka)
Non-poisonous (Nirvish Jaloka)
- Shankh Mukhi
Shrunga (Blood Letting Using Cow’s Horn)
In this procedure the selected cow’s horn is collected which is open at both ends, this is mainly used in Vata vitiated rakta. Small and multiple incisions are made over the affected area. The one side of the horn is placed at the incised skin and from the other side suction is created by the mouth which leads to blood letting. This procedure can be compared with cupping therapy.
Hemapheresis is the process used in vitiated blood, as our body grows the blood gets affected by various types of environmental factors and by toxins. In Hemapheresis one or more components are withdrawal to achieve the health of the patient. Vitiated blood causes in many blood disorders ie, Rakta pradosja vikara, in blood disorders it is very important to purify the blood. Ayurveda includes two main therapies ie. Rakta shodhana and Rakta mokshana and the bloodletting therapy by leech is one of the most easy and beneficial procedures in the Rakta mokshana. The procedures which are given in this article only remove the vitiated blood from the body. The herbs which are described here are used to pacify the blood and also provide strength to the immune system and have no side effects.