Complications During Adsorptive Cytapheresis Treatment

Adsorptive cytapheresis is a non-pharmacological treatment primarily used in mild-moderate, chronically active ulcerative colitis, and cortisone-resistant or -dependent patients. Some evidence supports its use when biologics and immunomodulators are ineffective or contraindicated in ulcerative colitis and in selected cases of Crohn’s disease, pustular psoriasis, pyoderma gangrenosum, rheumatoid arthritis, and other inflammatory arthritis. Extracorporeal adsorptive circuits selectively remove activated granulocytes, monocytes, and lymphocytes, reduce proinflammatory cytokines, upregulate Treg cells, and reduce inflammation. The safety profile is excellent as serious adverse events directly attributable to the procedure are rare, if not exceptional. Mild-moderate adverse events occurring in 5–20% of procedures mainly result from venous access problems, venous pressure abnormalities, and coagulation in system lines or are caused by anticoagulants. Headache, fever, and dizziness are the most common adverse events directly related to the procedure. The need for stopping apheresis sessions does not exceed 2% of the procedures and rarely requires further treatment. The safety profile is better than that of conventional pharmacological treatment, including steroids, immunosuppressants, and biologics, making adsorptive apheresis a viable alternative to standard therapy in selected patients.