Alternative techniques to the traditional plasma exchange are emerging in clinical practice for the treatment of different pathological conditions, particularly autoimmune diseases. Filtration is a technique used to separate blood cells from plasma, which may be further "treated" with other filters or columns. The case for cascade filtration and absorption onto a column is becoming stronger and stronger and the patient population is increasing. Alongside the "historical" techniques of adsorption onto a column, new systems (pairs of self-regenerating columns) and new products (columns with dextran sulphate, tryptophane, anti-human lipoprotein antibodies) are now available. Protein A in particular seems to open up new horizons; in therapeutic plasmapheresis, there are two versions, one Swedish and the other American, based on different theoretical premises and obtaining different results, with different biocompatibilities but good clinical results.