It is used in diseases featuring high LDL, such as the rarehomozygousfamilial hypercholesterolemia, when the heterozygous form does not respond to medical treatment, or when the treatment has led to dangerous side-effects (such as rhabdomyolysis).
The procedure takes 2-4 hours and must be repeated every several weeks to keep the LDL levels from accumulation and causing cardiovascular disease.
It is an expensive procedure, limiting its use to severe cases of hyperlipidemia.
Principles
LDL apheresis works by leading venous blood through a collumn coated with antibodies to apolipoprotein B (the main protein of LDL particles), dextran sulphate or polyacrylate, or by precipitating LDL with heparin at low pH. In all cases (apart from polyacrylate absorption), plasma is separated from cells by a cell separator.
References
Thompson GR. LDL Apheresis. Atherosclerosis 2003;167:1-13. PMID 12618263.
Vella A, Pineda AA, O'Brien T. Low-density lipoprotein apheresis for the treatment of refractory hyperlipidemia. Mayo Clin Proc 2001;76:1039-46. PMID 11605688.
Apheresis (Greek: "to take away") is a medical technology in which the blood of a donor or patient is passed through an apparatus that separates out one particular constituent and returns the remainder to the circulation.
Various blood components are obtained by apheresis from donors.
The various apheresis techniques may be used whenever the removed constituent is causing severe symptoms of disease.
In medicine, LDLapheresis is a form of apheresis, resembling dialysis, to eliminate the cholesterol-containing particle low-density lipoprotein (LDL) from the bloodstream.
It is used in diseases featuring high LDL, such as the rare homozygous familial hypercholesterolemia, when the heterozygous form does not respond to medical treatment, or when the treatment has led to dangerous side-effects (such as rhabdomyolysis).
LDLapheresis works by leading venous blood through a collumn coated with antibodies to apolipoprotein B (the main protein of LDL particles), dextran sulphate or polyacrylate, or by precipitating LDL with heparin at low pH.
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