Double Filtration Plasmapheresis for Environmental Toxin Removal: A Case Series of Patients With Hyperlipoproteinemia(a)

Double filtration plasmapheresis (DFPP) is a promising method for removing environmental toxins, but comparative data on toxin-specific removal patterns remain limited. This study investigates the removal effectiveness of various pollutants in patients with hyperlipoproteinemia(a) undergoing DFPP. We retrospectively analyzed procedures performed using the Inuspheresis System with two filters with differing pore sizes. We assessed the clearance of heavy metals, volatile organic compounds, and organic pollutants by calculating the "redistribution ratio" (RR) and the percentage of captured analyte (CA). Analytes with large volumes of distribution and low protein binding, such as toluene, methyl isobutyl ketone, and barium, showed high rebound (RR: 1.95, 1.31, and 1.97, respectively), suggesting redistribution from peripheral compartments. Moderate rebound was observed for partially protein-bound toxins, including PCB 153 (0.76), PCB 138 (0.74), and hexachlorobenzene (0.66). Low or negative RRs were seen with arsenic (-0.49), mercury (-0.05), and cobalt (0.08), likely reflecting limited redistribution. High CA values were recorded for lipophilic, protein-bound toxins such as PCBs and p,p'-DDE. Herein, we demonstrate that DFPP is effective in removing environmental toxins from the human body. The pharmacokinetic properties of each compound are key determinants of DFPP effectiveness and may help guide the development of personalized detoxification strategies to optimize its clinical use.