Related Experiment Video
Updated: May 14, 2026
06:47
Isolation and Analysis of Plasma Lipoproteins by Ultracentrifugation
Published on: January 28, 2021
How to optimize lipoprotein apheresis treatment--a second look.
V Schettler1, C L Neumann, G C Hagenah
1Nephrologisches Zentrum Göttingen GbR, Göttingen, Germany. v.schettler@nz-goe.de
Atherosclerosis. Supplements
|January 30, 2013
Summary
Lipoprotein apheresis (LA) effectively lowers LDL-C and Lp(a), but optimal treatment volumes are often miscalculated. Increasing volumes by 1.3-fold and assessing individual capacity may improve LA effectiveness for cardiovascular disease patients.
Area of Science:
- Cardiovascular Medicine
- Medical Technology
Background:
- Lipoprotein apheresis (LA) is a vital treatment for hypercholesterolemic patients with cardiovascular disease (CHD) unresponsive to diet and medication.
- Standard formulas for calculating plasma volume (PV) and blood volume (BV) are used to determine LA treatment volumes for lowering LDL-cholesterol (LDL-C) and lipoprotein (a) (Lp(a)).
- However, not all patients achieve target LDL-C (<70 mg/dl) and Lp(a) (<30 mg/dl) levels with current LA protocols, necessitating optimization strategies.
Purpose of the Study:
- To investigate methods for increasing the effectiveness of lipoprotein apheresis (LA) in achieving target lipid concentrations.
- To compare actual treated volumes with calculated plasma volume (PV) and blood volume (BV) in patients undergoing LA.
- To determine the capacity threshold of LA procedures to optimize treatment capacity independent of calculated volumes.
Main Methods:
- Patients undergoing regular LA had their actual treated volumes compared to calculated PV and BV over time.
- Treatment volumes were stepwise increased to achieve target cholesterol concentrations.
- During LA procedures, cholesterol, triglycerides, LDL-C, HDL-C, and Lp(a) were measured every 20 minutes and related to hematocrit to account for dilution effects.
Main Results:
- Actual treated volumes in LA patients were significantly different from calculated volumes: 28 ± 18% for PV (n=7) and 28 ± 20% for BV (n=6).
- A mean increase of 1.3-fold in treated volumes compared to calculated volumes was necessary to achieve target cholesterol levels in most LA treatments.
- Only one patient (1/13) experienced ineffective long treatment times, and no procedures failed due to exhausted capacity.
Conclusions:
- Lipoprotein apheresis (LA) is highly effective for lowering LDL-C and Lp(a), but calculated volumes (PV, BV) can be error-prone.
- Increasing calculated LA volumes by approximately 1.3-fold is a potential first step to optimize individual treatment.
- Determining individual capacity thresholds can further refine LA treatment volumes and prevent procedure exhaustion, though further data are needed.
