Extracorporeal immunoadsorption with protein A: Technical aspects and clinical results

The use of therapeutic plasma exchange (TPE) for removal of large molecular‐weight substances form patients' circulation is limited by the method's non‐selectivity and non‐specificity. In order to remove the target amount of pathogenic substance, usually amounting to less than 1 g per liter of plasma, one will also remove 60‐80 g of proteins, some of which are essential. A further disadvantage of the method is the need for substitution fluids, which at least in some countries are expensive and of limited availability. Furthermore, there is a (low) risk of disease transmission. To overcome these limitations, the principle of affinity chromatography used in biochemistry was applied in medicine to develop the Excorim Extracorporeal Immunoadsorption System in the beginning of the 1980s [1].