Application of a new LDL apheresis system using two dextran sulfate cellulose columns in combination with an automatic column-regenerating unit and a blood cell separator.
Extracorporeal procedures for selective removal of low-density lipoproteins have become a promising new approach for treatment of severe familial hypercholesterolemia. We tested efficacy and safety of a new LDL apheresis system by using two dextran sulfate cellulose adsorbents (Liposorber LA 15TM from Kanegafuchi) under the control of an automatic column-regenerating unit for continuous alternate adsorption and desorption. Plasma was taken from a continuous-flow blood cell separator (model IBM/Cobe 2997) allowing an extracorporeal circuit from one cubital vein to another. A 57-year-old male with drug-resistant heterozygous familial hypercholesterolemia accompanied by moderate hypertriglyceridemia and severe coronary artery disease has been treated every 2 weeks for 3 months so far. Treatment of 4-5 liters of plasma resulted in a mean decrease of total cholesterol from 355 to 111 mg/dl (9.20 to 2.88 mmol/l), of LDL cholesterol from 272 to 49 mg/dl (7.05 to 1.53 mmol/l), and of apolipoprotein B from 175 to 44 mg/dl. HDL cholesterol, apolipoprotein A-I, and other plasma proteins did not substantially change apart from hemodilution. No side effects were seen. This new technique of LDL apheresis represents a very effective and safe method for treatment of drug-resistant familial hypercholesterolemia without or with concomitant hypertriglyceridemia.
Knisel
W
W
IV. Department of Internal Medicine, University of Tübingen, Federal Republic of Germany.
Müller
M
M
Besenthal
I
I
di Nicuolo
A
A
Rebstock
M
M
Risler
T
T
Eggstein
M
M
D000327:Adsorption; D001161:Arteriosclerosis / Q000209:etiology / Q000517:prevention & control; D001781:Blood Component Removal / Q000295:instrumentation*; D002469:Cell Separation / Q000295:instrumentation; D002482:Cellulose; D002784:Cholesterol / Q000097:blood; D002846:Chromatography, Affinity; D016264:Dextran Sulfate; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000097:blood / Q000150:complications / Q000628:therapy*; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008875:Middle Aged
D008077:Lipoproteins, LDL; D002482:Cellulose; D016264:Dextran Sulfate; D002784:Cholesterol