A Comparative Analysis between Nanomembrane-Based Therapeutic Plasmapheresis and Other Plasmapheresis Methods and Their Potential Use during the COVID-19 Pandemic

Abstract

During a plasmapheresis session, a centrifugation device or membrane-based replacement equipment removes a portion of blood plasma, and separates pathologic macro-molecules from the patient´s blood for therapeutic purposes. The removed substances include alloantibodies, autoantibodies, cytokines, toxins, monoclonal proteins, lipoproteins and other plasma components. The American Society for Apheresis (ASFA) reviews its clinical indications for various medical fields, such as hematology, oncology, neurology, rheumatology and nephrology. In addition, a relevant aspect about plasmapheresis is that it is an effective adjuvant treatment for acute liver failure, peripheral vascular disease, Guillain- Barre syndrome, sepsis, Disseminated Intravascular Coagulation (DIC) and Thrombotic Thrombocytopenic Purpura (TTP), which are all possible complications of Coronavirus Disease 2019 (COVID-19). Different organizations around the world have made much progress in plasmapheresis´ biomedical engineering. One of such advances is the creation of more practical equipment and of a filter for nanomembrane-based therapeutic plasmapheresis. The nanopores of this multi-membrane filter allow for a more specific and less traumatic blood filtration. This process requires a single needle insertion and functions with an extracorporeal volume of only 70 mL, thus reducing risks and allowing its use even for pediatric patients. Other advantages include its relative lower cost, the short duration of treatment and the fact that donor plasma as a replacement fluid is optional, reducing in that way the risk of infection and allergic reactions. This comparative review will focus on these advantages and also on the aforementioned potential applications of nanomembrane-based therapeutic plasmapheresis for some of the complications of COVID-19.