Selective removal of low density lipoproteins (LDL) by precipitation at low pH: first clinical application of the HELP system.
The first clinical application of a new extracorporeal procedure (HELP) for the selective elimination of low-density lipoproteins by heparin precipitation at acid pH is described. Plasma, obtained by filtration of whole blood through a 0.2 mu filter, is continuously mixed with an equal volume of an acetate buffer (pH 4.85) containing heparin. After removal of the precipitated heparin complex by filtration, excess heparin is adsorbed to a specially developed filter and the clear plasma filtrate is subject to bicarbonate dialysis/ultrafiltration to restore physiologic pH and remove excess fluid. The calculated efficiency for the elimination of low-density lipoproteins from plasma by HELP is 100% and is therefore comparable to conventional plasmapheresis. The HELP system shows a high degree of specificity with over 80% of total protein being returned to the patient. Over 130 treatment procedures have now been performed. Patient compliance and acceptance have been excellent and no major complications have been observed.
D000328:Adult; D001769:Blood; D011232:Chemical Precipitation; D003131:Combined Modality Therapy; D003327:Coronary Disease / Q000628:therapy; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000097:blood / Q000628:therapy*; D008077:Lipoproteins, LDL / Q000097:blood*; D008079:Lipoproteins, VLDL / Q000097:blood; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D014462:Ultrafiltration / Q000295:instrumentation*
D008077:Lipoproteins, LDL; D008079:Lipoproteins, VLDL; D006493:Heparin