Hematologist Sotiris Koumas issues a clear warning against the use of plasmapheresis outside of established therapeutic indications, emphasizing to CNA that it is a medical procedure that can cause mild to serious complications and "must be performed in specialized centers."
In relation to its use for anti-aging, Mr. Koumas states that he does not know if it is applied in Cyprus, underlining that "the first rule of medicine is to do no more harm."
Speaking to CNA, on the occasion of the public debate that has arisen around the death of Giorgos Mazonakis and the reports that have been made regarding plasmapheresis and anti-aging, Mr. Koumas clarified that he does not participate in this public debate, while explaining what plasmapheresis is and in which cases it is used as a therapeutic method.
As he mentioned, plasmapheresis is a specific medical therapeutic procedure, which has a wide scope of application in several medical specialties, including hematology and neurology, while in some cases it is also used in rheumatology.
He explained that this is essentially a process of exchanging the patient's plasma.
Plasma is the liquid component of blood, in which various molecules are transported, including proteins, antibodies and clotting factors.
In pathological conditions, he added, pathological proteins, autoantibodies or other substances may increase in this fluid component, which may cause harm to the patient if not treated.
Timely implementation is crucial
He cited thrombotic thrombocytopenic purpura as a typical example, noting that in several cases plasmapheresis is required and that early diagnosis and initiation of treatment can be crucial for survival.
"The earlier you make the diagnosis, the earlier you start plasmapheresis – and we're talking hours – the better the patient's chances of survival," he said.
Mr. Koumas also expressed satisfaction with the level of cooperation that has been achieved in public hospitals in Cyprus, in dealing with cases requiring plasmapheresis.
As he explained, such a process may require the cooperation of hematologists, nephrologists, intensivists and surgeons, as well as specialized nursing staff.
He cited as an example an incident in which, as he said, the initial diagnosis was made within one hour and within four hours the machine was available to start plasmapheresis.
"There is the team, there is the specialized nursing staff," he said, noting that this is a procedure that requires specialization and the ability to immediately address possible complications.
From bleeding to arrhythmia
Referring to possible complications, the hematologist noted that these can be mild, but also particularly serious.
As he said, catheter placement can cause injury or bleeding, while the catheter, which remains in place for as long as the sessions are needed, can become infected or clot.
During plasmapheresis, he explained, the patient's blood passes through a special machine and filters, the plasma is removed, while the blood cells (red and white blood cells and platelets) are returned to the patient.
At the same time, he said that fluid is administered to replenish the plasma that is removed.
"This fluid may, depending on the indication and method, be plasma from donors," he noted.
Mr. Koumas explained that plasma, as a biological agent, can cause an allergic reaction, which may require anything from simple anti-allergic treatment to more significant medical interventions.
In addition, there may be a drop in blood pressure or electrolyte disturbances, which in some cases can lead to arrhythmia.
He stressed, however, that these are known risks of the procedure, which can be addressed in an appropriate hospital environment.
"That is why plasmapheresis must be performed in specialized centers, for specific therapeutic indications," he noted.
Don't know if it is used for anti-aging
Asked whether plasmapheresis is used in Cyprus for anti-aging purposes and not for the treatment of a specific disease, Mr. Koumas replied that he was not aware of it.
He referred to the competent authorities, who, he said, can inform about the purposes for which this specific method is applied and whether there is a relevant indication within the framework of approved scientific protocols.
"I, in public, apply the therapeutic approach within the framework of the introductory protocol," he said.
Mr. Koumas also noted that he has not investigated how many centers in Cyprus have the ability to perform therapeutic plasmapheresis, while he referred to centers that have recently opened and the publicity that has been given to this specific method.
"Controls must also be strengthened"
In relation to the operating framework of such centers in Cyprus, the hematologist stated that the competent authority is the Ministry of Health, through the General Directorate of Medical Services and Public Health Services.
As he explained, there are supervisors and inspectors and specific conditions that facilities and services must meet in order to be licensed.
He noted, however, that beyond the technical framework, substantial control of the services provided should also be ensured.
"Controls must also be strengthened. And yes, everyone must be controlled," he said.
"Do no more harm"
Asked what he would answer to a person who asked him for plasmapheresis solely for anti-aging purposes, Mr. Koumas replied: "It's not his specialty, I don't know."
At the same time, he invoked the fundamental rule of medicine, which according to him is "do no more harm."
"Even in a patient, who is a patient, if you don't know, it's better not to intervene, not to do more damage," he said.
Referring to prevention, he noted that medicine can effectively intervene in factors such as cholesterol, smoking and alcohol consumption.
"Doctors often say that prevention is 50% of the cure," he said.
Mr. Koumas noted, finally, that in cases treated with therapeutic plasmapheresis in public hospitals, the results, as he said, are "within the framework of international success and failure figures", underlining that as with any medical treatment, "there are also failures".
Source: KYPE
