Immunoadsorption (IA) selectively removes certain plasma proteins. IA can be specific (only removing antibody specific for single antigen) or nonspecific (removing all antibodies). Although several IA systems are available worldwide, none are currently used in the United States. This chapter…
Low-density lipoprotein (LDL) apheresis (LA) removes apo-B containing lipoprotein (LDL and lipoprotein(a) [Lp(a)]). The primary indication for LA is familial hypercholesterolemia (FH), an autosomal dominant disorder of cholesterol metabolism, resulting in elevated plasma LDL-C levels. Numerous LDL-C removal methodologies are…
Extracorporeal photopheresis (ECP) involves the ex vivo exposure of peripheral blood mononuclear cells (MNCs), including pathogenic or autoreactive T-lymphocytes, to photoreactive 8-methoxypsoralen (8-MOP) and ultraviolet A (UVA) light, followed by reinfusion of these MNCs. ECP was first successfully used for the…
Therapeutic leukocytapheresis (or leukapheresis) is a procedure in which white blood cells (WBCs) are selectively removed from patient’s circulation, generally with the aim of treating hyperleukocytosis and/or hyperviscosity. Additionally, leukocytapheresis has been performed prophylactically, such as to prevent tumor lysis…
Therapeutic thrombocytapheresis (or commonly referred to as plateletpheresis or platelet depletion) is used in primary and sometimes secondary thrombocytosis to rapidly remove platelets for prevention or treatment of hemorrhage and/or thrombosis. Reduction of platelet count achieved by this procedure is…
Therapeutic erythrocytapheresis (ET) is a procedure in which patients’ RBCs are selectively removed to reduce excessive RBC mass. It has been used for treatment of polycythemia vera, reactive erythrocytosis, and hereditary hemochromocytosis. RBC exchange (RBCx) is a procedure in which…
Therapeutic plasma exchange (TPE) is a procedure in which whole blood of the patient is passed through an apheresis device, which separates and removes plasma. Other components are returned to the patient together with replacement fluid. Pathophysiology TPE is used…
Apheresis is derived from a Greek word “aphairesis,” which means “to remove forcibly.” Whole blood is removed from a subject, separated into components extracorporeally (RBCs, white blood cells, platelets, and plasma), desired blood component is removed, and remaining components are…