The history of Apheresis began with the first work of Dr. S. J. Thompson in London and a. Postiglione in Naples. Already in the 60-er years one came to remove the idea LDL by plasmapheresis. Due to the extensive introduction in the late 80-er and by recently introduced PCSK9 inhibitors and clinically proven value of the removal of extra extracorporeal lipoproteins (a), the apheresis treatment is used more and more often in practice. Nevertheless, the number of patients requiring Lipoproteinapherese treatment is increasing steadily.
In the therapeutic apheresis (from Gr. ἀφαιρέιν “Take Away”), colloquially also referred to as blood wash or purification procedure, it is a method of extra extracorporeal, i.e. the removal of pathogenic (disease-making) or surplus constituents (proteins, protein-bound substances and cells) from the blood or blood plasma of the patient. After the pathogenic substances have been removed, the “purified” blood is returned.
The therapeutic apheresis is a recognized therapy method and includes methodologically different techniques:
• The Unselective plasmapheresis in which the plasma is separated from the blood and completely substituted. As replacement liquids, most human blood products such as Albuminlösung or frozen fresh plasma (“Fresh frozen Plasma”, FFP) are used. This method is also known as plasma exchange.
• Selective plasmapheresis (also called plasma perfusion), in which the pathogenic substances or proteins are separated from the plasma by filtration or adsorption and the purified plasma is then returned to the patient, for example Lipidapherese, immune adsorption or Rheopherese.
• The Vollblutapherese (also: hemoperfusion), in which the pathogenic substances are filtered directly from the blood. Here, too, there are applications in the form of Lipidapherese or immune adsorption.
Principle of the LP-Apheresis
