The blood column in the transfusion set and in the central venous catheter will be cleared with normal saline mixed heparin solution attached previously through the side channel. The blood bag will be hung beside the patient in a saline stand uninterrupted to separate the plasma and blood cells which will eventually take 2.5 hours with gravitation. Blood cells will be infused back to the patient and plasma will be discarded and replaced by Fresh Frozen Plasma (FFP) and colloid solution alternately in equal volume through the side channel. One blood bag will be used each day for 6 sessions. At the beginning of each session 70 ml of heparin solution will be taken in the blood bag from the heparin mixed normal saline as anticoagulant. Six sessions will be done daily for consecutive 8 days. A total of 48 sessions will be done in eight days. These six sessions of small volume plasma exchange per day in an adult patient will remove approximately 1200 ml of plasma daily and eventually 9600 ml of plasma will be removed in total 48 sessions. All connection ports and tri channels of the central venous catheter, the blood bag and the saline bag are disinfected by using alcohol 70% then dried on air before sampling blood or (dis)connection. These procedures are performed aseptically. Internationally, endorsed guidelines on central venous catheter blood stream infection prevention is followed throughout the entire period of the SVPE procedure. Total active interference with the patient in each session will be 30 minutes and total daily active interference with the patient will be three hours with a Daily schedule at 8AM, 11AM, 2PM, 5PM, 8PM and 11PM. Plasma replacement will be done alternately using fresh frozen plasma and colloid solution (Hexa ethyl starch).