Plasmapheresis is performed through either centrifugation or membrane plasma separation. Centrifugation technique is the same technology used by blood banks to process blood and can be done with either intermittent or continuous flow. Blood components are separated out according to density, and plasma or cells can be removed. Intermittent flow requires only one venipuncture site but can be associated with more hypotension since larger volume shifts are needed. Continuous flow requires two venous access sites or a double-lumen catheter capable of handling high flow states. Membrane filtration technique can be used with hemodialysis equipment and uses a special filter that allows only plasma to pass through pores. Different filters or hemadsorption columns can be used depending on the indication.

A plasmapheresis treatment session usually removes 1 to 1.5 plasma volumes. Autoantibodies, immune complexes, toxins or substances bound to proteins, immunoglobulins, thrombotic factors, coagulation factors, lipoproteins, and other immunologic factors are removed during plasmapheresis for a number of different immunologic, hematologic, neurologic, renal, rheumatologic, and metabolic disorders. Replacement fluid usually consists of 60% to 80% albumin with the rest of the solution being normal saline. However, fresh frozen plasma can be used as the replacement solution when there is a concern for bleeding or in the treatment of certain conditions such as thrombotic thrombocytopenic purpura or hemolytic uremic syndrome. Anticoagulation is required for these treatments with citrate used for centrifugation, while unfractionated heparin is used for membrane filtration.