Hemoperfusion and Immunomodulation.

Recent development in sorbent technology has spurred new interest in the potential of hemoperfusion (HP) in clinical conditions such as cytokine release syndromes and sepsis. Although the role of nonselective HP in such conditions requires solid evidence and more studies, the rationale for clinical application is clearly emerging. Greater biocompatibility and safety of the new sorbents may allow easy and safe application of HP in those conditions where the innate and the adaptive immune response of the individual appears to be dysregulated. Recent results in small studies seem to confirm the plausibility for this therapeutic approach. The concept suggested by the peak concentration hypothesis justifies new studies and the application of HP in selected patients to remove the peaks of circulating mediators responsible for conditions of hyperinflammation or immunodepression.