ABSTRACT
This chapter reviews the status and future prospects of alternative procedures in which the collected plasma is treated to remove the pathological components thus allowing the useful proteins to be returned to the patient. Closed-loop plasmapheresis intrinsically eliminates the need for plasma replacement and thus the associated problems of side reactions secondary to the replacement fluid infusion. The therapeutic rationale for closed-loop plasmapheresis is that clinical benefit results from the removal of pathogenic molecules and not from the addition of substitution fluid. Possibly, the scale of porosity in the second filter will be reduced closer to that used in cascade filtration, providing a hybrid process exploiting the separative capability of both fractional precipitation and selective ultrafiltration. The appeal of immunoadsorption is in its specificity. In principle, immunoadsorption is capable of removing the offending pathogen and nothing else. The matrices for immunoadsorption vary widely.
