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Therapeutic Plasma Exchange Using Membrane Plasma Separation.

Sadiq Ahmed¹, Andre Kaplan²

¹Division of Nephrology Bone and Mineral Metabolism, University of Kentucky, Lexington, Kentucky.

Clinical Journal of the American Society of Nephrology : CJASN

|April 22, 2020

Summary

Therapeutic plasma exchange (TPE) removes harmful large molecules from blood. Membrane separation TPE, compatible with CRRT systems, is increasingly accessible to nephrologists for toxin removal.

Keywords:

Antibodies Artificial Centrifugation Kidneys Lipoproteins Molecular Weight Nephrologists Plasma Exchange Plasmapheresis clinical nephrology renal dialysis ultrafiltration

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Area of Science:

Nephrology
Blood Purification
Medical Technology

Background:

Therapeutic plasma exchange (TPE) is a blood purification method targeting large molecular weight toxins like pathogenic antibodies and lipoproteins.
TPE can be achieved via membrane separation or centrifugation, with regional preferences (centrifugal in the US, membrane in Germany/Japan).
Membrane separation utilizes large-pore membranes, akin to ultrafiltration, to remove plasma components while retaining blood cells.

Purpose of the Study:

To review membrane separation techniques for therapeutic plasma exchange available in the United States.
To outline practical considerations for implementing membrane separation TPE procedures.
To discuss potential complications associated with membrane separation TPE.

Main Methods:

Description of membrane separation techniques for TPE.
Discussion of ordering and operational aspects of the procedure.
Review of potential complications.

Main Results:

Membrane separation TPE is similar to standard dialysis ultrafiltration but with larger pores.
Compatibility of plasma separation membranes with Continuous Renal Replacement Therapy (CRRT) systems broadens accessibility.
The review covers US-based techniques, procedural logistics, and complications.

Conclusions:

The integration of plasma separation membranes with CRRT systems enhances TPE accessibility for nephrologists.
Understanding the practicalities and potential complications of membrane separation TPE is crucial for effective implementation.
This review provides a comprehensive guide to membrane separation TPE in the US context.