Abstract
Double-filtration plasmapheresis is an advanced extracorporeal blood purification technique that selectively removes pathogenic macromolecules based on molecular weight. Unlike conventional plasma exchange, double-filtration plasmapheresis uses a two-step filtration process to retain beneficial plasma components such as albumin, while eliminating harmful substances, thereby reducing the need for exogenous plasma replacement. Over the last few decades, double-filtration plasmapheresis has gained prominence in the management of refractory autoimmune, neurological, metabolic, and renal diseases. This review systematically examines the therapeutic mechanisms, recent clinical advances, safety, limitations, and prospects of double-filtration plasmapheresis.