Overview of therapeutic apheresis in the U.S.A.

This article provides an overview of therapeutic plasma exchange in the United States. The original continuous flow blood cell separator was developed in the U.S.A. and remains the most popular type of equipment used. Treatments are expensive and limited by insurance reimbursement. Covered diseases are already established, with most of the treatments falling into those for hematologic and neurologic diseases. The majority of therapeutic plasma exchange is performed for a limited number of diagnoses. An estimated 110,000 treatments were provided in 1997, the majority in hospital-based units. It is unclear whether these numbers will increase or decline with the increasing limitations in reimbursement by insurance companies.