G.J. Tijhuis, J.J. van Doormaal MD, L. Rijskamp, C.Th.Smit Sibinga MD, PhD, H. Doorenbos MD, PhD
{"title":"Plasma exchange and low-density lipoprotein filtration therapy in heterozygous familial hypercholesterolemia","authors":"G.J. Tijhuis, J.J. van Doormaal MD, L. Rijskamp, C.Th.Smit Sibinga MD, PhD, H. Doorenbos MD, PhD","doi":"10.1016/0278-6222(88)90029-0","DOIUrl":null,"url":null,"abstract":"<div><p>We studied serum lipids during and shortly after a single plasma exchange (PE) on seven separate occasions in four patients, and during long-term treatment by regular PE in three patients with heterozygous familial hypercholesterolemia. Also, a comparison was made for efficacy in lipid and apolipoprotein removal between long-term weekly PE therapy and three consecutive weekly low-density lipoprotein (LDL) filtration procedures in one patient. PE was done by intermittentflow centrifugation (IFC) with Haemonetics V50 apparatus, exchanging one plasma volume. LDL filtration consisted of a cascade PE, in which the plasma was separated by IFC and the LDL fraction was subsequently removed by membrane filtration over a polyalcohol filter (Evaflux<sup>®</sup>). From the results, we concluded that (1) LDL cholesterol is reduced about 50% by both methods; (2) after PE, high-density lipoprotein (HDL) cholesterol does not increase during the first two hours, but rises thereafter faster than LDL cholesterol and can reach baseline within three days; (3) by LDL filtration, HDL cholesterol decreases about 30% less than LDL cholesterol and tends to increase above the starting levels found during weekly PE treatment; (4) the reductions in LDL and HDL cholesterol are larger than those in apolipoprotein B and A-I, respectively, in both methods; and (5) connection of the LDL filter device to the Haemonetics V50 system simplifies the cascade procedure, resulting in a single needle approach and avoidance of hemolysis in the primary plasma separation.</p></div>","PeriodicalId":101030,"journal":{"name":"Plasma Therapy and Transfusion Technology","volume":"9 1","pages":"Pages 29-34"},"PeriodicalIF":0.0000,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0278-6222(88)90029-0","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Plasma Therapy and Transfusion Technology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/0278622288900290","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
Abstract
We studied serum lipids during and shortly after a single plasma exchange (PE) on seven separate occasions in four patients, and during long-term treatment by regular PE in three patients with heterozygous familial hypercholesterolemia. Also, a comparison was made for efficacy in lipid and apolipoprotein removal between long-term weekly PE therapy and three consecutive weekly low-density lipoprotein (LDL) filtration procedures in one patient. PE was done by intermittentflow centrifugation (IFC) with Haemonetics V50 apparatus, exchanging one plasma volume. LDL filtration consisted of a cascade PE, in which the plasma was separated by IFC and the LDL fraction was subsequently removed by membrane filtration over a polyalcohol filter (Evaflux®). From the results, we concluded that (1) LDL cholesterol is reduced about 50% by both methods; (2) after PE, high-density lipoprotein (HDL) cholesterol does not increase during the first two hours, but rises thereafter faster than LDL cholesterol and can reach baseline within three days; (3) by LDL filtration, HDL cholesterol decreases about 30% less than LDL cholesterol and tends to increase above the starting levels found during weekly PE treatment; (4) the reductions in LDL and HDL cholesterol are larger than those in apolipoprotein B and A-I, respectively, in both methods; and (5) connection of the LDL filter device to the Haemonetics V50 system simplifies the cascade procedure, resulting in a single needle approach and avoidance of hemolysis in the primary plasma separation.