Apheresis is an effective desensitization modality for removing antibodies against donor-specific human leukocyte antigens or ABO blood type antigens to facilitate transplantation. Apheresis is also used to treat acute antibody-mediated rejection, in conjunction with immunosuppressive medications, in recurrent focal and segmental glomerulosclerosis and other glomerular diseases, in correction of coagulopathy, in supportive therapy in acute liver failure patients awaiting liver transplant, and in the treatment of drug-induced thrombotic microangiopathy. Transplant recipients who receive apheresis need close monitoring for infections and for potential bleeding complications associated with surgery or biopsy.