cTPE or mTPE involves separating patient’s plasma from other components of blood to remove pathological factors like autoimmune antibodies, donor-specific antibodies, cytokines, excessive paraproteins and endogenous and exogenous toxins (e.g., IgG in MG, anti-GM1, anti-GD1a antibodies in GBS, IgM in Waldenström macroglobulinemia, or IgG and IgM iso-agglutinins prior to ABO incompatible organ transplantation, anti-aquaporin IgG in neuromyelitis optica) [7,8,9]. This evidence concerns the gene CD40LG and Waldenstrom macroglobulinemia.