Solute removal of double filtration plasmapheresis therapy (DFPP) and plasma exchange therapy (PE) with albumin solution

Abstract

Acute blood purification therapy is widely applied in emergency medicine. In particular, therapeutic plasma exchange (PE) or double filtration plasmapheresis (DFPP) is the treatment of choice for acute exacerbation episodes of autoimmune diseases. When PE and DFPP using albumin solution as replacement fluid are compared, in order to remove 65% of serum IgG, it is necessary to exchange 0.9 plasma volumes (PV) in PE and 1.15 PV in DFPP. On the other hand, removal of fibrinogen is 64% in PE and 75% in DFPP. PE using albumin as replacement solution requires less amount of patient plasma volume to be exchanged with smaller loss of fibrinogen compared to DFPP. Taking account of its relatively simple maneuver, PE using albumin as replacement solution is a considerable option of treatment for pathogenic antigen removal.