ABSTRACT
Therapeutic plasma exchange is generally associated with the removal of large quantities of plasma and its associated coagulant proteins. Affinity adsorption apheresis involves the selective extraction of immunologic or non-immunologic substances from the circulation by means of a column, with the benefit of returning non-extracted proteins, such as clotting factors, to the patient. An unintended consequence of hemapheresis is potential reduction in circulating drugs. Adverse reactions associated with therapeutic apheresis are uncommon. Sickle cell anemia is an inherited abnormality of hemoglobin synthesis resulting in the formation of hemoglobin S instead of hemoglobin A. Understanding of clinical indications for hemapheresis have been based on objective evidence of efficacy gleaned through published clinical and basic research. Small uncontrolled case series in lung transplants with bronchiolitis obliterans and chronic rejection have reported improvement or stabilization of declining pulmonary function with photopheresis.
