The advantages are the elimination of pathologic substances and the interruption of pathogenic reactions. The disadvantages are the unselective elimination of all proteins by the unselective methods, the possible complications and the high costs. The authors try to define the indications of different methods of therapeutic apheresis.
In recent years numerous new selective, respectively semi-selective, separation methods have been introduced into everyday clinical practice, such as various immune absorption, full blood absorption, or other techniques. All these processes are still technically very complicated and expensive. It is the task of manufacturers to develop simpler and less costly techniques.
Especially in the case of illness with a very poor prognosis despite intensive therapy, therapeutic plasma exchange can often have a positive influence in the acute phase. For example the combination of various extracorporeal detoxification measures in liver failure seems to be very promising.
Recognised plasmapheresis indications in Germany are: Goodpasture syndrome, Guillain-Barre syndrome, hemophilia, hyperglobulinemia, microglobulinemia, myasthenia gravis, pemphigus vulgaris, polyneuropathy, systemic lupus erythematosus, thyreotoxic crisis, thrombocytopenic purpura, vasculitis, acute exogenic intoxication, liver cirrhosis, familiar hypercholesterolemia.
Therapeutic Plasma Exchange and Selective Plasma Separation Methods
Fundamental Technologies, Pathology and Clinical Results
Bambauer, Rolf; Latza, Reinhard; Schiel, Ralf