Review|Articles in Press, 103675

Basic principles of therapeutic plasma exchange

  • Robert Weinstein
    Correspondence to: Department of Medicine, University of Massachusetts Chan Medical School, 1020 Avery Meadows Way, DeLand, FL 32724, USA.
    Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA
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Published:February 24, 2023DOI:


      Therapeutic plasma exchange is a method of treatment for clinical conditions that represent diverse fields of medicine. The rationale for this mode of therapy is based on sound mathematical modeling of the synthesis and removal of large molecules, usually proteins, from the circulation. The basic assumptions underlying therapeutic plasma exchange are that a clinical illness is caused by, or related to, a pathogenic substance in the plasma, and that removing that substance from the plasma will alleviate the patient’s illness. This approach has proven applicable to a wide variety of clinical conditions. Therapeutic plasma exchange is largely a safe procedure in experienced hands. The principal adverse effect, the hypocalcemic reaction, is readily ameliorated or prevented.


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