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Therapeutic plasmapheresis and plasma exchange
Critical Reviews in Clinical Laboratory Sciences
|January 1, 1986
Summary
Plasma exchange removes harmful substances from blood but its effectiveness varies. Despite initial enthusiasm, controlled studies show less dramatic results, and its role in treating over 100 diseases remains undefined due to complications.
Area of Science:
- Immunology
- Therapeutic Apheresis
Background:
- Plasma exchange (PEX) involves replacing large plasma volumes with donor plasma or substitutes.
- This procedure removes various plasma constituents like antibodies, immune complexes, and toxins.
- PEX may modulate the immune system by affecting the reticuloendothelial system and lymphocyte function.
Purpose of the Study:
- To evaluate the efficacy and defined role of plasma exchange in clinical practice.
- To assess the impact of PEX on over 100 different diseases.
- To reconcile initial promising reports with findings from controlled studies.
Main Methods:
- Review of literature on plasma exchange applications and outcomes.
- Analysis of results from controlled studies versus uncontrolled case reports.
- Assessment of reported complications and mortality associated with PEX.
Main Results:
- Plasma exchange can remove a wide range of pathological plasma components.
- Variable success rates reported across over 100 treated diseases.
- Controlled studies yielded less impressive results compared to earlier case reports.
Conclusions:
- Initial enthusiasm for plasma exchange has been tempered by variable efficacy and reported complications.
- The precise clinical role of plasma exchange remains undefined despite extensive investigation.
- Further research is needed to clarify the therapeutic indications and risks of PEX.