Automated erythrocytapheresis in the treatment of severe falciparum malaria

Removal of parasitized erythrocytes is generally considered to be of value as adjunctive therapy in severe falciparum malaria with high parasitaemia. This is commonly achieved by exchange transfusion, We describe three cases of severe falciparum malaria treated by automated erythrocytapheresis (rfd cell exchange) in addition to quinine and conventional supportive therapy. Erythrocytapheresis consists of removal of the red-cell fraction by apheres is. Plasma, leukocyte and platelet fractions are returned to the patient. I n all cases, dramatic reduction in parasitaemia was achieved within 2 h wit h subsequent complete clinical recovery. Erythrocytapheresis has significan t advantages over exchange transfusion in terms of speed, efficiency haemod ynamic stability and retention of plasma components such as clotting factor s and may thus represent an improvement in adjunctive therapy for severe ma laria. (C) 1999 The British Infection Society.