What apheresis is and how it works
Apheresis refers to a group of extracorporeal procedures in which blood is separated outside the body. Depending on the specific procedure, certain blood or plasma components are removed, or the plasma is partially or completely replaced. The remaining or treated blood components are then returned to the circulatory system.
Which components are targeted and how selective the treatment is depends on the apheresis procedure used. Consequently, the various methods differ in terms of their mechanism of action, target structures, and medical indications.
Therapeutic apheresis procedures include plasmapheresis, therapeutic plasma exchange (TPE), lipoprotein apheresis, and immunoadsorption.
Who benefits from apheresis
Therapeutic apheresis procedures are used for specific medical indications. The appropriate procedure depends on the underlying condition, the specific target structure, and the individual clinical situation.
· Lipoprotein apheresis can be used for severe lipid metabolism disorders that cannot be sufficiently controlled despite optimized lipid-lowering therapy. In cases of isolated elevated lipoprotein(a), it is considered particularly when Lp(a) levels are significantly high and cardiovascular disease is progressing despite consistent management of other risk factors.
· Therapeutic plasma exchange (TPE) is used for specific immunological, neurological, and hematological conditions, such as thrombotic thrombocytopenic purpura (TTP) and in certain clinical situations involving myasthenia gravis or Guillain-Barré syndrome.
· Immunoadsorption is used for the targeted removal of immunoglobulins or pathogenic autoantibodies and can be applied in selected antibody-mediated diseases, such as certain neurological autoimmune disorders.
· Plasmapheresis procedures (including double filtration plasmapheresis - DFPP) are used for selected, clearly defined indications where the removal of specific disease-relevant plasma components is therapeutically beneficial. Depending on the specific procedure, these include, for example, certain immunologically mediated, neurological, or hematological diseases.
Apheresis at Buff Medical Resort
At Buff Medical Resort, we use double filtration plasmapheresis (DFPP) for selected patients following an individual medical assessment. This requires a thorough medical history and diagnostic evaluation, as well as a personalized benefit-risk analysis. Depending on the clinical picture, double filtration plasmapheresis may be considered as a therapeutic option for certain immune-mediated conditions. While clinical data on the use of DFPP exists for specific autoimmune diseases, the indication and clinical significance of the procedure vary depending on the condition and the patient's clinical situation.
In cases of confirmed elevated exposure to certain environmental pollutants, the potential application of this procedure can also be evaluated on an individual basis. Studies show that certain per- and polyfluoroalkyl substances (PFAS), for example, can be removed from the plasma via DFPP. However, whether and to what extent this results in a clinically relevant health benefit has not yet been conclusively determined; its use for this purpose is not currently an established, guideline-based standard therapy.
As this is an invasive extracorporeal procedure, a medical indication must be established prior to any treatment. This involves weighing the available evidence, potential treatment alternatives, and individual risks against the potential benefits, all of which are discussed in detail with guests at Buff Medical Resort.
Learn more about which therapy options are suitable for your individual situation.
FAQ
What is lipoprotein apheresis?
Lipoprotein apheresis is an extracorporeal procedure used to specifically reduce atherogenic lipoproteins, particularly LDL and lipoprotein(a), from the blood or plasma. It is used for selected patients with severe lipid metabolism disorders, such as familial hypercholesterolemia, when sufficient control cannot be achieved despite exhaustive or maximally tolerated lipid-lowering therapy.
When is apheresis appropriate?
Therapeutic apheresis procedures are used for selected medical indications. Since the individual procedures differ in their mechanisms of action and target structures, the indication is determined on an individual basis, specific to both the procedure and the disease.
What is lipoprotein(a) and why is it relevant?
Lipoprotein(a), or Lp(a) for short, is a predominantly genetically determined lipoprotein and an independent risk factor for atherosclerotic cardiovascular disease and aortic valve stenosis. Lp(a) levels are barely influenced by lifestyle changes, and statins do not lead to a significant reduction either. Elevated Lp(a) levels are associated with an increased risk of cardiovascular events such as heart attack and stroke. While lipoprotein apheresis can effectively lower Lp(a), it is only used for specific medical indications.
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