Immunoadsorption is a procedure that removes specific

blood Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the c ...

group antibodies from the blood. It is needed to remove the antibodies against

pathogen In biology, a pathogen ( el, πάθος, "suffering", "passion" and , "producer of") in the oldest and broadest sense, is any organism or agent that can produce disease. A pathogen may also be referred to as an infectious agent, or simply a germ ...

antibodies An antibody (Ab), also known as an immunoglobulin (Ig), is a large, Y-shaped protein used by the immune system to identify and neutralize foreign objects such as pathogenic bacteria and viruses. The antibody recognizes a unique molecule of the ...

. The procedure generally takes about three to four hours. Immunoadsorption was developed in the 1990s as a method of extracorporeal removal of molecules from the

, in particular molecules of the

immune system The immune system is a network of biological processes that protects an organism from diseases. It detects and responds to a wide variety of pathogens, from viruses to parasitic worms, as well as cancer cells and objects such as wood splinte ...

. Different number of devices/columns exist on the market, each with a different active component to which the molecule of interest attaches, allowing for selectivity in the molecules of interest. Immunoadsorption may be used as an alternative to

plasma exchange Plasmapheresis (from the Greek πλάσμα, ''plasma'', something molded, and ἀφαίρεσις ''aphairesis'', taking away) is the removal, treatment, and return or exchange of blood plasma or components thereof from and to the blood circulati ...

in certain conditions. Evidence of benefit is lacking in those with

kidney The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blood ...

problems. Concerns include that it is expensive.

Procedure

Dual column system

Blood first passes to

plasma Plasma or plasm may refer to: Science * Plasma (physics), one of the four fundamental states of matter * Plasma (mineral), a green translucent silica mineral * Quark–gluon plasma, a state of matter in quantum chromodynamics Biology * Blood pla ...

filter. Plasma then passes on to immunoadsorption column before returning to patient. As the plasma is passing through one column, the second column is being regenerated. Once the first column is saturated the flow switches to the second column while the first is then regenerated. -1st step: the separation of plasma from the blood cells -2nd step: the immunoadsorption column Treatment prescriptions for immunoadsorption are based on plasma volumes with different recommendations for each condition and depending on the condition being treated, sessions can be daily or intermittent.

The therapy

Immunoadsorption could be used in various autoimmune-mediated neurological diseases in order to remove autoimmune antibodies and other pathological constituents from the patients blood It is increasingly recognized as a more specific alternative and generally appreciated for its potentially advantageous safety profile. Immunoadsorption is also used in kidney transplantation for either the preparation of the

ABO The ABO blood group system is used to denote the presence of one, both, or neither of the A and B antigens on erythrocytes. For human blood transfusions, it is the most important of the 43 different blood type (or group) classification system ...

-incompatible or the highly sensitized kidney transplant candidate before transplantation, or the treatment of antibody-mediated rejection after transplantation.

Indication

The most frequently encountered complication of immunoadsorption is an

allergic reaction Allergies, also known as allergic diseases, refer a number of conditions caused by the hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include hay fever, food allergies, atopic derma ...

to the filter or adsorption column. Medication may be given before the procedure to minimize the risk. Other side effects during the treatment could be dizziness, nausea or feeling cold. The usage of immunoadsorption as medical procedure is still limited in some countries of the world, especially in Northern America. The additional costs for immunoadsorption are balanced by the reduced

length of stay Length of stay (LOS) is the duration of a single episode of hospitalization. patient, Inpatient days are calculated by subtracting day of admission from day of :wikt:discharge, discharge. Analysis A common statistic associated with length of stay ...

time as well as the reduced need of plasma substituting solutions and handling of side effects.

Procedure

Dual column system

The therapy

Indication

References

Further reading