Though whole lung lavage is standard treatment for pulmonary alveolar proteinosis (PAP) some patients are offered other types of treatment. This is typically because WLL does not have the intended effect or because the patients are not suited for the treatment.
Some patients undergo a procedure called plasmapheresis. Plasmapheresis is a process that filters the blood and removes harmful antibodies by removing the plasma portion of the blood where antibodies are located. In PAP patients, GM-CSF antibodies are removed from the blood preventing it from inactivating the GM-CSF proteins.
As there are no approved medical treatments for PAP yet, the doctors use their medical judgement in selecting the best treatment for each patient.