RHEOPHERESIS AND ITS USE IN THE TREATMENT OF DISEASES WITH IMPAIRED MICROCIRCULATION. A REVIEW

Česká verze

Authors: A. Paříková
Authors place of work: Klinika Nefrologie, Transplant Centrum, Institut Klinické, a Experimentální Medicíny
Published in the journal: Čes. a slov. Oftal., 79, 2023, No. 1, p. 3-5
Category: Přehledový článek
doi: https://doi.org/10.31348/2023/1

Summary

Rheopheresis ranks among apheretic methods. It is a selective, extra-corporeal double cascade filtration treatment. First, the plasma is separated from blood elements in extra-corporeal circulation by passing through membrane filter. The plasma is then filtrated through the second filter in order to remove proteins with a high molecular mass, e.g. lipids, fibrinogen, α2-macroglobulin, von Willebrand factor, immunoglobulin IgM. The purified plasma is then returned together with the blood elements back to the patient. The aim of the procedure is to improve the microcirculation and rheological properties of the blood. Rheopheresis is well established method for the treatment of age-related macular degeneration, acute sensorineural hearing loss, calciphylaxis, systemic sclerosis or peripheral vascular disease.

Keywords:

plasmapheresis – Macular degeneration – apheresis – rheopheresis

Zdroje

1. Kosmadakis G. Rheopheresis: A narrative review. Int J Artif Organs. 2022 May; 45(5):445-454.

2. Blaha M, Andrys C, Langrova H, et al. Changes of the complement system and rheological indicators after therapy with rheohemapheresis. Atheroscler Suppl. 2015 May; 18:140-145.

3. Heigl F, Hettich R, Lotz N, et al. Indication and implementation of lipidapheresis, rheopheresis, or immunoadsorption (lessons learnt from Germany’s largest apheresis center). Atheroscler Suppl. 2009 Dec; 10(5):137-141.

4. Kirschkamp T, Schmid-Schönbein H, Weinberger A, Smeets R. Effects of fibrinogen and alpha2-macroglobulin and their apheretic elimination on general blood rheology and rheological characteristics of red blood cell aggregates. Ther Apher Dial. 2008 Oct; 12 (5):360-367.

5. Klingel R, Fassbender C, Fassbender T, Erdtracht B, Berrouschot J. Rheopheresis: rheologic, functional, and structural aspects. Ther Apher. 2000 Oct; 4(5):348-357.

6. Koss MJ, Kurz P, Tsobanelis T, et al. Prospective, randomized, controlled clinical study evaluating the efficacy of Rheopheresis for dry age-related macular degeneration. Dry AMD treatment with Rheopheresis Trial- -ART. Graefes Arch Clin Exp Ophthalmol. 2009 Oct; 247(10):1297-1306.

7. Thompson GR; HEART-UK LDL Apheresis Working Group. Recommendations for the use of LDL apheresis. Atherosclerosis. 2008 Jun;198(2):247-255.