- Therapeutic plasma exchange (TPE) using an automated cell separator removes harmful large molecules, such as antibodies, from the circulation.
- Human albumin (± saline) is the usual replacement fluid.
- Solvent detergent treated fresh frozen plasma should be used for TPE in thrombotic thrombocytopenic purpura.
- TPE is only indicated for conditions where there is good evidence it is effective and the benefits outweigh the risks.
- Therapeutic erythrocytapheresis (replacement of abnormal red cells) is mainly used to treat or prevent complications of sickle cell disease.
- Less commonly used therapeutic apheresis procedures include leucapheresis and plateletpheresis to reduce dangerously high white cell or platelet counts, extracorporeal photopheresis to inactivate T-lymphocytes and column immunoadsorption to remove specific antibodies.