Authoritative, evidence-graded clinical guidance covering 106 disease conditions, all major apheresis procedures, and 14 clinical calculators — for clinicians and patients alike.
This reference serves clinicians, students, and patients. Choose your path for a tailored experience.
ASFA categories, GRADE evidence, procedure protocols, replacement fluid selection, and anticoagulation guidance.
Learn how apheresis works, understand the technology, and explore the evidence framework behind clinical decisions.
Plain-language explanations of what apheresis is, what to expect during treatment, and how to prepare.
Therapeutic apheresis is a family of medical procedures that remove blood from a patient, separate it into components using centrifugal or membrane-based technology, selectively remove or modify one or more components, and return the treated blood to the patient.
Unlike simple blood transfusions, apheresis allows clinicians to precisely target and remove pathogenic substances — such as autoantibodies, abnormal lipoproteins, malignant cells, or toxins — that drive disease.
The field is governed by the American Society for Apheresis (ASFA), which publishes evidence-based guidelines classifying indications into four categories and grading the underlying evidence using the GRADE methodology.
Each procedure targets a specific blood component or pathogenic substance.
Removes and replaces patient plasma, eliminating circulating autoantibodies, immune complexes, and toxins. The most widely performed apheresis procedure.
Selectively removes and replaces patient RBCs with donor cells. Primary treatment for sickle cell disease crises and severe malaria.
Treats mononuclear cells with a photoactive compound and UVA light before reinfusion. FDA-approved for cutaneous T-cell lymphoma and GvHD.
Selectively removes low-density lipoproteins from plasma. Category I first-line therapy for familial hypercholesterolemia unresponsive to medication.
Passes plasma through a column that selectively binds immunoglobulins or specific antibodies. Can process 2–3 plasma volumes without replacement fluid.
Selectively removes white blood cells to treat hyperleukocytosis in leukemia, preventing respiratory or neurological compromise from leukostasis.
Category I — first-line apheresis therapy with the strongest evidence.
Life-threatening thrombotic microangiopathy caused by ADAMTS13 deficiency. TPE is the cornerstone of treatment, rapidly removing auto-antibodies and replenishing the enzyme.
Acute inflammatory demyelinating polyneuropathy. Plasma exchange and IVIg are equally effective first-line treatments, supported by multiple randomized controlled trials.
Genetic disorder causing severely elevated LDL-cholesterol. LDL apheresis is first-line when drug therapy is inadequate, reducing cardiovascular event risk by up to 70%.
Rapidly progressive glomerulonephritis caused by anti-glomerular basement membrane antibodies. TPE rapidly clears circulating antibodies to prevent irreversible renal damage.
Autoimmune neuromuscular junction disease. TPE rapidly removes acetylcholine receptor antibodies, providing short-term improvement for myasthenic crisis or pre-surgical optimization.
RBC exchange reduces sickle hemoglobin percentage rapidly, halting stroke progression and preventing recurrence. Preferred over simple transfusion to avoid iron overload.
Key statistics from Apheresis Reference — grounded in ASFA guidelines and current apheresis evidence.
With over 22 neurological indications, the nervous system represents one of the most important application domains for therapeutic apheresis. Many of these conditions — GBS, MG, CIDP, NMDA encephalitis — involve pathogenic autoantibodies that plasma exchange can effectively remove.
The ASFA Neurological Practitioner's guide provides specialized protocols for common and rare neuroimmunological conditions, including detailed frequency, volume, and replacement fluid recommendations.
Neurological Indications →Clinical Disclaimer: This website is intended for educational and informational purposes only. Content reflects published ASFA guidelines and AABB standards but does not constitute medical advice. Therapeutic decisions require individualized clinical judgment by qualified healthcare professionals. Some Category III and IV indications remain controversial — guidelines should be interpreted in the context of the individual patient.