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 plasma exchange: Prescription and technique" and "Therapeutic plasma exchange: Complications".)
The use of TPE in specific disorders is discussed in separate topic reviews. (See 'General therapeutic categories' below.)
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.