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Updated: Apr 6, 2026
Isolation and Analysis of Plasma Lipoproteins by Ultracentrifugation
Published on: January 28, 2021
Lipoprotein-apheresis: Austrian consensus on indication and performance of treatment
Kurt Derfler1, Sabine Steiner, Helmut Sinzinger
1Department of Internal Medicine III, Division of Nephrology and Dialysis, AKH, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Insights
Familial lipid metabolism disorders are more common in Europe. Lipoprotein apheresis is a safe and effective treatment for severe cases, significantly reducing vascular events in eligible patients.
Area of Science:
- Cardiology
- Metabolic Disorders
- Medical Technology
Background:
- Familial disorders of lipid metabolism are prevalent in Europe.
- Conventional lipid-lowering therapies may be insufficient for severely affected patients.
- Elevated lipoprotein(a) and atherosclerotic progression necessitate advanced treatments.
Purpose of the Study:
- To compare Austrian lipoprotein apheresis inclusion criteria with international standards.
- To evaluate the efficacy and safety of lipoprotein apheresis in managing lipid disorders.
- To analyze the impact of lipoprotein apheresis on clinical events and interventions.
Main Methods:
- Comparative analysis of apheresis inclusion criteria across Austria, Italy, Germany, Spain, Japan, UK, and the US.
- Review of clinical data on regular weekly lipoprotein apheresis.
- Assessment of lipid and lipoprotein parameter reduction.
- Evaluation of clinical event and intervention rates.
Main Results:
- Austrian lipoprotein(a) cutoff (100 mg/dl) is higher than in other countries (50-60 mg/dl).
- Regular weekly lipoprotein apheresis significantly lowers atherogenic lipids and lipoproteins.
- Lipoprotein apheresis leads to a significant decrease in clinical events and interventions.
- The therapy is safe and effective for patients meeting inclusion criteria.
Conclusions:
- Lipoprotein apheresis is a crucial therapeutic option for severe familial lipid disorders.
- It effectively reduces vascular events, even with normal low-density lipoprotein-cholesterol levels.
- Comparing international guidelines highlights variations in treatment accessibility.
Abstract:
The prevalence of familial disorders of lipid metabolism in Europe is higher than believed so far. In severely affected patients in whom conventional combined lipid lowering agents are insufficient to achieve target values, patients being intolerant to all the available members of the statin family as well as in patients with elevated lipoprotein(a) (100 mg/dl) and progression of atherosclerotic vascular disease, despite even normal low-density lipoproteins (LDL)-cholesterol values, lipoprotein-apheresis treatment is indicated. The Austrian Apheresis Consensus compares the inclusion criteria for patients to be treated in Austria with those from Italy, Germany, Spain, Japan, UK and the United States. The cut off level of 100 mg/dl for lipoprotein(a) is higher in Austria as compared to the aforementioned countries (50 or 60 mg/dl, respectively). The available clinical data reveal that regular weekly lipoprotein apheresis not only results in a significant lowering of the respective atherogenic lipid and lipoprotein parameters, but also in a significant decrease in clinical events and interventions. The underlying mechanisms such as non-lipid effects, side effects as well as the different available treatment principles are compared. For patients meeting the inclusion criteria, lipoprotein apheresis is a safe and effective therapy significantly reducing vascular events.
