CURRENT INDICATIONS OF THERAPEUTIC PLASMAPHERESIS

After an euphoric decade of expanding indications for the plasma exchange treatment, since 1985 a disillusionment took place induced by the publication of the results of controlled clinical trials. By the improvement of the immunosuppressive treatment as well as the further development of the plasmapheresis towards a more selective therapy the use of plasma exchange treatment in the field of nephrology was restricted markedly. But for the Goodpasture syndrome and the Moschcowitz syndrome (HUS/TTP) the plasmapheresis is still now the treatment of choice, whereas for the rapidly progressive glomerulonephritis, the lupus nephritis and for the kidney graft rejection there exist better therapeutic modalities up to now. In the area of neurology for severe myasthenia gravis and Guillain-Barre syndrome the therapeutic plasmapheresis advanced to standard treatment, but the use of high-dose immunoglobulin therapy seems promising.