Therapeutic plasma exchange: a technical and operational review

J Clin Apher. 2013 Feb;28(1):3-10. doi: 10.1002/jca.21257.


Therapeutic plasma exchange (TPE) is an extracorporeal blood purification technique designed for the removal of large molecular weight substances. Examples of these substances include pathogenic autoantibodies, immune complexes, cryoglobulins, myeloma light chains, endotoxin and cholesterol containing lipoproteins. The basic premise of the treatment is that removal of these substances will allow for the reversal of the pathologic processes related to their presence. This review will cover the techniques for performing TPE, the kinetics of the removal of large molecules from the plasma and the benefits and risks of the different types of replacement fluids.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Anticoagulants / adverse effects
  • Anticoagulants / pharmacology
  • Blood Volume
  • Electrolytes / administration & dosage
  • Filtration / methods
  • Humans
  • Immunoglobulins / blood
  • Macromolecular Substances / blood
  • Osmolar Concentration
  • Plasma
  • Plasma Exchange / adverse effects
  • Plasma Exchange / instrumentation
  • Plasma Exchange / methods*
  • Serum Albumin / administration & dosage


  • Anticoagulants
  • Electrolytes
  • Immunoglobulins
  • Macromolecular Substances
  • Serum Albumin