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Therapeutic plasma exchange: Indications

Joy L Fridey, MD
Andre A Kaplan, MD
Section Editor
Arthur J Silvergleid, MD
Deputy Editor
Jennifer S Tirnauer, MD


Therapeutic plasma exchange (TPE, plasmapheresis) is an automated extracorporeal apheresis technique designed to remove or reduce the concentration of large molecular weight substances from the plasma. Examples of these substances include pathogenic autoantibodies, immune complexes, cryoglobulins, myeloma light chains, endotoxin, and cholesterol-containing lipoproteins (table 1).

Indications for TPE will be discussed here. The prescription, technique, and complications of TPE are discussed separately. (See "Therapeutic apheresis (plasma exchange or cytapheresis): Indications and technology" and "Therapeutic apheresis (plasma exchange or cytapheresis): Complications".)

The use of TPE in specific disorders is discussed in separate topic reviews. (See 'General therapeutic categories' below and "Therapeutic apheresis (plasma exchange or cytapheresis): Indications and technology".)


The following terminology is used to describe procedures related to plasma exchange:

Apheresis – An umbrella term for "taking away" a blood component. Apheresis includes plasmapheresis (taking away plasma) and hemapheresis (taking away blood cells). Of note, we do not use the term "pheresis," which is a shortened pronunciation (slang) for apheresis.


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Literature review current through: Oct 2015. | This topic last updated: Dec 13, 2013.
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