Lipoprotein apheresis efficacy and challenges: single center experience


Özdemir Z. N., Şahin U., Yıldırım Y., Kaya C., İLHAN O.

Hematology, Transfusion and Cell Therapy, cilt.44, ss.56-62, 2022 (Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 44
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1016/j.htct.2021.01.009
  • Dergi Adı: Hematology, Transfusion and Cell Therapy
  • Derginin Tarandığı İndeksler: Scopus
  • Sayfa Sayıları: ss.56-62
  • Anahtar Kelimeler: Lipoprotein apheresis, Hyperlipidemia, Apheresis technique, LOW-DENSITY-LIPOPROTEIN, CORONARY-HEART-DISEASE, FAMILIAL HYPERCHOLESTEROLEMIA, LDL-APHERESIS, FOLLOW-UP, MULTICENTER
  • Ankara Üniversitesi Adresli: Evet

Özet

© 2021Introduction: Lipoprotein apheresis (LA) is an extracorporeal therapy which removes apolipoprotein B-containing particles from the circulation. We evaluated techniques and efficiency of lipoprotein apheresis procedures applied to patients with familial and non-familial hypercholesterolemia (FH) at our center. Methods: We retrospectively evaluated 250 LA procedures applied to 27 patients with dyslipidemia between March 2011 and August 2019. Results: A total of 27 patients, of whom 19 (70.4%) were male and 8 (29.6%), female, were included. Eighteen (66.7%), 6 (22.2%) and 3 (11.1%) patients were diagnosed with non-FH, homozygous FH (HoFH) and heterozygous FH (HeFH), respectively. Two different apheresis techniques, direct adsorption of lipoproteins (DALI) (48.8%) and double filtration plasmapheresis (DFPP) (51.2%), were used. The change in the serum total cholesterol (TC) level was the median 302 mg/dl (171–604 mg/dl) (60.4%) in HoFH patients, 305 mg/dl (194–393 mg/dl) (60.8%) in HeFH patients and 227 mg/dl (75–749 mg/dl) (65.3%) in non-FH patients. The change in the serum low-density lipoprotein (LDL) level was the median 275 mg/dl (109–519 mg/dl) (64.2%), 232 mg/dl (207–291 mg/dl) (64.5%) and 325 mg/dl (22–735 mg/dl) (70.9%) in patients with HoFH, HeFH and non-FH, respectively. A significantly effective reduction in serum lipid levels, including TC, LDL and triglycerides, was achieved in all patients, regardless of the technique, p < .001. The decrease in the serum TC and LDL levels was significantly higher in the DFPP, compared to the DALI, being 220 mg/dl (−300 to 771) vs 184 mg/dl (64–415), p < .001 and 196 mg/dl (11–712) vs 157 mg/dl (54–340), p < .001, respectively. Conclusions: Our results showed that LA is a highly effective treatment in reducing serum lipid levels and safe, without any major adverse event.