Double filtration Plasmapheresis (DFPP)

🩺 What is Blood Purification?

Double-Filtration Plasmapheresis (DDFP) is an advanced blood purification technique categorized under therapeutic apheresis. It is primarily used to remove harmful large-molecule substances from the blood—such as antibodies, immune complexes, lipoproteins, and cholesterol—while retaining beneficial small-molecule proteins like albumin.

Blood purification physically removes certain impurities from the blood. It has been widely practiced abroad for over 30 years and is considered a mature, stable, low-risk treatment with minimal side effects.

🧪 Why Undergo Blood Purification?

Modern dietary habits and high-stress lifestyles often lead to the accumulation of metabolic waste and physiological burdens. These can cause cardiovascular and metabolic circulation problems.

With refined diets, sedentary routines, irregular schedules, and stress, many people unknowingly accumulate excess substances in their blood that cannot be properly absorbed or metabolized. This increases blood viscosity and reduces circulation to vital organs, raising the risk of cerebrovascular and cardiovascular diseases. Environmental pollutants and stress further contribute to chronic inflammation and immune imbalances.

🔬 Key Functions of DDFP

✅ 1. Removes Pathogenic Macromolecules
Effectively filters out large harmful molecules in the plasma, such as:

• Autoantibodies (e.g., anti-ANA, anti-dsDNA, antiphospholipid antibodies)

• Immune complexes

• Inflammatory cytokines

• Abnormal lipoproteins (e.g., LDL in hypercholesterolemia)

✅ 2. Preserves Essential Proteins
DDFP uses selective filtration, unlike traditional plasma exchange which removes the entire plasma, DDFP retains small proteins like albumin and clotting factors, avoiding the need for large volumes of fresh frozen plasma or albumin, thereby reducing side effects.

✅ 3. Common Indications
DDFP is widely used for treating the following conditions:

1. Autoimmune Diseases:

   • Systemic lupus erythematosus (SLE)

   • Rheumatoid arthritis

   • Multiple sclerosis

   • Myasthenia gravis

   • Goodpasture's syndrome

2. Kidney Diseases:

   • Rapidly progressive glomerulonephritis

   • Lupus nephritis

   • Anti-GBM nephritis

3. Lipid Disorders:

   • Familial hypercholesterolemia (for LDL removal)

4. Neurological Disorders:

   • Guillain-Barré syndrome

   • Chronic inflammatory demyelinating polyneuropathy (CIDP)

5. Transplant Rejection Prophylaxis:

   • Reduces donor-specific antibodies to lower rejection risk

   • Hematologic diseases like cryoglobulinemia, TTP, etc.

🔍 DDFP and Chronic Inflammation

Chronic inflammation is a shared pathological mechanism in many diseases, such as autoimmune, metabolic, cardiovascular, and neurodegenerative disorders. It often involves:

• Autoantibodies and immune complexes

• Chronically activated immune cells and pro-inflammatory cytokines

• Oxidative stress and abnormal lipoprotein metabolism

DDFP targets and removes these inflammatory macromolecules, thereby reducing systemic inflammation.

🧪 Specific Benefits of DDFP for Chronic Inflammation

✅ 1. Elimination of Pro-inflammatory Factors:

• Immune complexes

• Autoantibodies

• Inflammatory cytokines (e.g., IL-6, TNF-α)

• C-reactive protein (CRP) and other acute-phase proteins

This helps suppress immune overactivation and chronic inflammation.

✅ 2. Reduces Immune-Mediated Tissue Damage
In conditions like SLE, RA, or MS, DDFP reduces immune complex deposition in tissues, thereby limiting organ damage.

✅ 3. Improves Clinical Symptoms and Inflammatory Markers
Reported effects include:

• Lower CRP and ESR levels

• Reduced joint pain and swelling

• Alleviated fatigue, myalgia, and brain fog

Validated in patients with lupus, Sjögren's syndrome, skin inflammation, and kidney disorders.

✅ 4. Safe and Repeatable
No need for large plasma infusions, reducing allergy/infection risk.
It can be performed periodically to maintain long-term inflammation control.

📌 Suitable for Which Chronic Inflammatory Conditions?

• Systemic lupus erythematosus (SLE): clears antibodies and reduces inflammation

• Rheumatoid arthritis (RA): reduces joint-damaging factors

• Multiple sclerosis (MS): mitigates neuroinflammatory attacks

• Chronic glomerulonephritis: removes circulating immune complexes

• Chronic allergic skin diseases (e.g., eczema): reduces excess IgE and inflammatory mediators

• Chronic fatigue syndrome / brain fog: experimental use shows partial relief

⚙️ How It Works (Mechanism)

DDFP involves two key filtration steps:

1. First filter: separates plasma from blood cells.

2. Second filter: selectively removes harmful macromolecules from the plasma while preserving beneficial small proteins. The purified plasma and blood cells are then returned to the body.

🧭 Key Advantages of DDFP

• Wide applicability: autoimmune, renal, neurological, metabolic diseases

• High selectivity: removes large inflammatory molecules, preserves albumin

• Fewer side effects: no need for large-volume blood product transfusions

• Excellent as adjunctive therapy: works well with immunosuppressants and biologics

• Effective for chronic inflammation: a promising option for treatment-resistant cases

◍ Suitable Candidates & Contraindications

✔ Recommended for:

• Individuals with poor metabolic health or high cardiovascular risk

• People under chronic stress

• Those with poor circulation or borderline hypertension/cholesterol/glucose

• Seniors over 65

⚠ Not suitable for the following without medical evaluation:

• Women during menstruation

• Patients with acute illness (e.g., fever, unstable blood sugar or pressure)

• Those undergoing active cancer therapy or with bleeding disorders

• Patients with severe anemia or low hemoglobin

◍ Pre-Treatment Notes

• Blood tests are conducted before and after to compare results.

• Dosage and duration are personalized based on weight and lab results.

• The process uses imported sterile kits and must be performed once opened.

• If the treatment is canceled after setup, a partial material fee may apply.

• Notify your doctor if you have cardiovascular conditions, allergies, or chronic illnesses.

• You may eat normally. Avoid spicy or unstable foods 2–3 days before treatment. Wear loose clothing.

◍ Post-Treatment Care

• Rest for ~30 minutes after the procedure to avoid dizziness.

• Apply pressure to the needle site for 20–30 minutes to prevent bleeding.

• Avoid massage, heavy lifting, or strenuous activity that day. No hot springs or spas.

• Bruising at the injection site is normal. Ice for 24 hours, then use heat.

• Mild fatigue or drowsiness may occur—rest well.

• Immune system may be lowered for 1–2 days—avoid crowds, wear a mask.

• Avoid smoking, alcohol, late nights, and fatty foods. Maintain healthy habits.

• Continue prescribed medications as advised by your doctor.

◍ FAQ

Q: How is blood purification different from dialysis?
A: DDFP removes harmful large molecules like lipoproteins, free radicals, and immunoglobulins. It helps with conditions such as high cholesterol, high uric acid, and chronic inflammation.
Dialysis (hemodialysis), on the other hand, mainly removes small molecules like urea and creatinine in kidney failure—it is a treatment for renal disease.

Q: Is one session enough?
A: It depends on individual health status and toxin buildup. Some may need repeated sessions.

Q: What does it feel like afterward?
A: Most people feel fine but may experience fatigue, drowsiness, or relaxation—these are normal.

Q: How long does a session take?
A: Usually 2–3 hours, depending on vascular access, blood lipid content, and circulation speed.