Double filtration plasmapheresis: Review of current clinical applications

Double filtration plasmapheresis (DFPP) is a semi-selective blood purification modality derived from the plasma exchange (PE) modality. In the DFPP treatment, two types of filters with different pore sizes are used: a plasma separator and a plasma component separator. Blood is separated into plasma and blood cells using a plasma separator. The separated plasma is fractionated into large and small molecular weight components by a plasma component separator. Large molecular weight components, including pathogenic substances, are discarded. Small molecular weight components, including valuable substances such as albumin, are returned to the patient. The advantage of DFPP is that the volume of replacement fluid can be significantly reduced compared to PE. By selecting the optimal pore size model for the plasma component separator, DFPP can be applied to various disorders. The clinical applications of DFPP are reviewed based on recent articles on metabolic disorders, organ transplants, rheumatic disorders, neurological disorders, and dermatologic disorders.