Abstract
Plasma exchange (or more appropriately therapeutic plasma ex change) is an extracorporal method belonging to therapeutic apheretic methods. It is used to remove pathogenic circulating plasmatic substances (e.g. autoantibodies in autoimmune diseases) or to substitute missing plasmatic factors (TTP).
In principle, membrane and centrifugal plasma exchange can be distinguished. To use plasma exchange in clinical practice, the supposed benefit should overweigh potential risks of the therapy.
Plasma exchange has a wide spectrum of indications that are regularly published in the Guidelines issued by the American Society for Apheresis (ASFA). In some cases, plasma exchange is urgent and considered first choice therapy, in others, it can be used as a rescue therapy.
In this paper, general data on the method will be mentioned (principles, necessary equipment, anticoagulation, substitute solutions, possible complications and their prevention). Plasma exchange use in selected nephrological diagnoses, e.g.
Goodpasture's disease or ANCA associated vasculitis, will be discussed.