ABSTRACT
The marriage of high technology and the ancient art of bloodletting has produced a rather remarkable as well as controversial phenomena in modern health care. Practically every subspecialty in clinical practice from psychiatry to dermatology and from neurology to hematology has reported the application of hemapheresis therapy to a growing list of diseases, usually with equivocal but occasionally startling results. The primary application of therapeutic hemapheresis has been for the reduction of an abnormal and/or clinically significant blood cell line or nondialyzable plasma factor with or without exchange for normal blood constituents. When experimentation grew in areas such as neurology, nephrology, and dermatology, consideration for who and what could more effectively provide the service, or decisions based upon who would control patient protocols, led to a plethora of various providers of therapeutic hemapheresis services. Another logical candidate for performing therapeutic hemapheresis, especially plasma exchange, are the dialysis clinics.
