Les échanges plasmatiques: Revue des principes, modalités et indications

Le terme « aphérèse » vient du grec aphairesis qui signifie séparer, enlever ou retirer par la force. L’aphérèse comprend une série de procédures dont le principe commun est basé sur la séparation du sang total en ses différents composants avec l’intention de retirer ou de modifier un de ses composants avant de le restituer au patient. Cet article se propose de revoir les différentes procédures d’aphérèse, les considérations techniques et leurs indications en pratique clinique. L’accent est mis sur les échanges plasmatiques dont les principes, modalités et indications sont exposés.

(eng) [Plasma exchange: a review of principles, methods and indications.] The word “apheresis” is derived from the Greek word “aphairesis,” which means “to separate,” “to take away by force,” or “to remove.” In the past, this term has been broadly utilized to describe several procedures, all of which involve the separation of whole blood into its components, with removal or modification of one or more of these components. This article is focused on plasma exchange, a therapeutic procedure used to treat a variety of diseases, involving the bulk removal of plasma. To apply this treatment appropriately, a sound understanding of the methods to remove plasma, its effects on normal plasma constituents, the role of replacement fluids in the treatment, as well as the risks associated with the procedure appears essential. The main indications for therapeutic plasma exchange have also been reviewed