Treatment of autoimmune diseases.
After transplantation, acute or chronic antibody-mediated rejection can lead to organ loss. In many cases where such rejection reactions do not respond sufficiently to drugs, they may be rapidly and effectively interrupted by an apheresis procedure like therapeutic plasma exchange orimmunoadsorption.1In patients with an increased risk of transplant rejection, a preventive removal of antibodies against histocompatibility or blood group antigens using immunoadsorption is a proven established modality.2Ģý5
Indications to be considered for therapeutic apheresis treatments (based on individualized decision making) include:25,26
GLOBAFFINEffective broad-spectrum immunoadsorption
To decrease the high plasma levels of IgG that play a major role in many neurological diseases, patients can be treated either through the use of immunoadsorption techniques that selectively reduce IgG or with plasma exchange, which is a rather unselective method.
The use of therapeutic plasma exchange or immunoadsorption to remove antibodies can be considered for intervention in the acute exacerbation of autoimmune diseases and in patients who do not respond, or only weakly respond, to immunosuppressive therapy.19,21
In addition to the mentioned indications, therapeutic apheresis can also be applied to:
GLOBAFFINEffective broad-spectrum immunoadsorption
Therapeutic apheresisin COVID-19
PDF, 84 KB1Böhmig GA et al. Am J Transplant 2007; 7:117-121
2Schwaiger E et al. Nephrol Dial Transplant 2016; 31(8):1342-1351
3Morath C et al. Transpl Int 2012; 25(5):506-517
4Bartel G et al. Am J Transplant 2010; 10(9):2033-2042
5Thölking G et al. PLoS One 2015; 10(6):e0131465
6Hamilton P et al. J Clin Apher 2022; 37:40-53
7Biesenbach P et al. PLoS One 2014; 9(7):e103568
8Dantal J et al. N Engl J Med 1994; 330(1):7-14
9Moriconi L et al. Ren Fail 2001; 23(3-4):533-541
10Meyer TN et al. Transpl Int 2007; 20(12):1066-1071
11Eming R et al. Dermatology 2006; 212(2):177-187
12Hübner F et al. J Dtsch Dermatol Ges 2018; 16(9):1109-1118
13Meyersburg D et al. Ther Apher Dial 2012; 16(4):311-320
14Eming R et al. Autoimmunity 2006; 39(7):609-616
15Kridin K et al. Dermatol Clin 2019; 37:215Ģý228
16Seta T et al. Clin Neurol Neurosurg 2005; 107:491-496
17Benny WB et al. Transfusion 1999; 39:682-687
18Dogan Onugoren M et al. Neurol Neuroimmunol Neuroinflamm 2016; 26; 3(2):e207
19Dorst J et al. EClinicalMedicine 2019; 16:98-106
20Hempel P et al. Ther Apher Dial 2016; 20(5):523-529
21Dorst J et al. J Mult Scler (Foster City) 2016; 3:178
22Dorst J et al. J Neurol 2018; 265:2906-2915
23Rech J et al. Ther Apher Dial. 2008;12(3):205-208
24Baggi F et al. J Neuroimmunol. 2008;201-202:104-110
25Padmanabhan A et al. J Clin Apher 2019; 34:171-354
26Chen YY et al. Ren Fail 2022; 44:842-857
27Richtlinie Methoden vertragsärztliche Versorgung; BAnz AT 30.03.2021 B4
28Heigl F et al. Atheroscler Suppl 2019;40:23-29
29Kosmadakis G Int J Artif Organs 2022;45(5):445-454
30Mehdi et al. Nephrol Dial Transplant 2019;34(S1):i234Ģý i235
31Pithova et al. Poster presented at the DFSG congress; 2017 Sept 8-10; Porto, Portugal
32Soltész et al. Orv Hetil 2021;162(10):375Ģý382
33Weinmann K et al. Biomolecules. 2018; 8(4):133
34Staudt et al. Clin Pharmacol Ther. 2010; 87(4):452-458
35Dandel M et al. Eur J Heart Fail. 2012; 14(12):1374-1388