[Efficacy of 2 cholesterol apheresis systems]

A new generation of techniques can be applied to the selective removal of some well-defined molecules from plasma. This is the field of plasma treatment. We investigated the selective removal of LDL cholesterol, by double filtration and dextran sulfate cellulose column plasmapheresis, from 3 to 4 liters of plasma from 4 hypercholesterolemic patients. The extraction rate of Apo A1 lipoprotein in dextran sulfate was less than 25% and Apo B was between 50 and 90%. Cascade filtration gave an extraction rate for Apo A1 between 25 and 50%; the extraction rate for Apo B was about the same as that found using the dextran sulfate procedure. Both techniques decreased the concentrations of coagulation factors (V, VIII and fibrinogen). In conclusion, we obtained good removal of LDL cholesterol with both systems. Dextran sulfate (from Kaneka) was more selective but very expansive. However, we observed side effects with this product that probably result from the release of dextran sulfate from the column.