Therapeutic apheresis: Technical modalities and therapeutic applications

Apheresis is a Greek word () which means removal of something from somewhere and was initially used in 1914. So Apheresis is the process by which plasma or cellular components are separated from the whole blood. This procedure is performed either on a blood donor, in order to supply the products to patients with different hematological or cancer diseases, or on a patient, alternatively as a therapeutic method. The process may be conducted by centrifugation and we can remove apart from the plasma, white blood cells, red blood cells as well as platelets. Furthermore, the process may be conducted by dialysis through a high permeability dialyzer which specifically removes plasma. Citrates or heparin are used as anticoagulants whereas fluid replacement comprises of albumin or fresh frozen plasma as well as colloidal starch when the procedure is plasma exchange. Complications are related to the vascular access, the anticoagulant or the replacement fluid (frequently with fresh frozen plasma). Now days an increased number of diseases are treated through apheresis procedures and this fact increased the interest of the medical world. Through this paper we focus on therapeutic apheresis principles as they are accepted worldwide, moreover contributing data from our 20 year experience in this field.