Hémaphérèse thérapeutique adulte et pédiatrique

The therapeutic hemapheresis developed at the end of the 70 s. Numerous protocols allowed to clarify indications and techniques (vascular access, anticoagulation, substitution fluids). At present 5 groups of pathologies (neurology, haematology, vasculitis, nephrology and endocrinology), represent more than 90% of the indications at the adult. In paediatrics the indications are identical with some supplementary specificities, but the number of children treated by plasma exchanges is slight because of the technical constraints and of few prospective studies, making prefer the therapeutic alternatives if they exist, in particular the IgIV. The development of hybrid devices, artificial kidney/ plasma separator, explains the increase of the patients number treated by plasma exchanges in intensive care units.