Zusammenfassung
Apheresen können ihre therapeutische Wirkung entfalten durch die Entfernung von pathologischen Komponenten, den Austausch von krankhaften Komponenten oder die Entnahme von kranken Komponenten, um sie außerhalb des Körpers zu behandeln. Der Beitrag stellt die verschiedenen Verfahren und Einsatzmöglichkeiten vor.
Abstract
Therapeutic apheresis is an evolving medical discipline which meanwhile is a fixed part of evidence-based medicine. The simple mathematic basis makes this supportive therapy predictable. There is a clear rationale behind the procedures: either a pathogenic substance is taken away, or harmful components are exchanged against healthy elements, or deficient plasma is substituted by plasma enriched with a needed factor in order to have “better” blood after the treatment. Apheresis procedures include centrifugal systems and filtration systems with special columns. Guidelines especially from the American Association for Apheresis (ASFA) and other societies provide high quality information about the indication and the level of evidence for this treatment in various disease stages. Continuously new systems, especially columns, are developed to ensure advancement in this field, and to open new fields for the use of therapeutic apheresis, like in hyperinflammation. Adaptations for
patients with small bodyweight, e.g., children, and patients in special situations make therapeutic apheresis procedures feasible in nearly every patient in need of this treatment.
Schlüsselwörter
therapeutische Apheresen - evidenzbasierte Medizin - Leitlinie - Guideline - individualisierte Medizin
Key words
therapeutic apheresis - evidence-based medicine - guidelines - individualized medicine
