In clinical practice, plasmapheresis is utilized to remove circulating immune complexes, endotoxins and high molecular weight molecules such as lipoproteins containing cholesterol. It is useful in certain diseases in rheumatology, oncology, dermatology and nephrology. Renal transplantation is the most exclusive treatment modality in end stage renal failure. Acute and chronic rejections along with the recurrence of the primary kidney disease at the post-transplant period shorten graft survival. Plasmapheresis treatment can be used both at the pre- and post-transplant period in cases of ABO incompatibility, highly sensitized patients, acute and chronic rejections, recurring glomerulonephritis and thrombotic microangiopathies.