Therapeutic Apheresis, Immunosuppression, and/or Human Monoclonal Antibodies in Cardiology

Therapeutic apheresis is an essential supportive treatment for severe and refractory diseases with or without immunologic origin. The advantages of therapeutic plasma exchange with hollow fiber membranes include a complete separation of the corpuscular components from the plasma and increased efficacy due to an elevated blood flow rate. Therapeutic apheresis has been shown to significantly improve the prognosis of idiopathic dilated cardiomyopathy, coronary heart disease, acute myocardial infarction and heart transplant rejection. This therapy is indicated as first- or second-line therapy in combination with immunosuppression, and/or human monoclonal antibodies and others. The immunologic and molecular biology of the different cardiologic diseases are mentioned and discussed in relation to rationale for apheresis therapy and its place with other modern therapy. The pathogenetically backgrounds are demonstrated in these cardiologic diseases, in which they are clarified. Therapeutic apheresis using hollow fiber membranes, and/or semi-, or selective columns is a safe and highly effective method for elimination of autoantibodies, immune complexes, inflammatory moderators, paraproteins and other toxins from blood, resulting in rapid clinical improvement in cardiologic diseases. The guidelines of the American Application Committee of the American Society for Apheresis are cited for cardiologic disease, which could be treated with therapeutic apheresis, immunosuppression and human monoclonal antibodies.