Centrifugation Selective Plasma Exchange: A Novel Hybrid Modality Combining Centrifugal Separation and Membrane-Based Plasma Fractionation.

BACKGROUND

Therapeutic plasma exchange (TPE) is widely used for autoimmune diseases; however, current modalities involve trade-offs between molecular selectivity and vascular access requirements. We developed a novel hybrid modality, centrifugation selective plasma exchange (cSePE), combining centrifugal plasma separation with membrane-based plasma fractionation.

METHODS

Seven patients with autoimmune diseases underwent cSePE (15 sessions) between April 2024 and June 2025. Solute concentrations before and after treatment were measured, and hematocrit-adjusted removal ratios (RRs) were calculated.

RESULTS

The mean RR of IgG was 65.7% ± 11.1%, while fibrinogen reduction was limited to 29.8% ± 9.9%. Disease-specific autoantibodies showed RRs exceeding 45%. Serum albumin levels remained unchanged. No treatment-related complications were observed.

CONCLUSIONS

cSePE enables selective removal of IgG fractions while preserving high-molecular-weight proteins and can be performed via peripheral venous access. This modality may represent a promising new option for plasma exchange in autoimmune diseases.