Lipoprotein apheresis efficacy and challenges: single center experience

Area of Science:

• Cardiovascular Medicine
• Nephrology
• Internal Medicine

Background:

• Lipoprotein apheresis (LA) is an extracorporeal therapy designed to remove apolipoprotein B-containing particles from circulation.
• It is a crucial treatment for managing severe hypercholesterolemia, including familial hypercholesterolemia (FH) and non-FH dyslipidemias.
• Evaluating the efficiency and techniques of LA is essential for optimizing patient care.

Purpose of the Study:

• To evaluate the techniques and efficiency of lipoprotein apheresis (LA) procedures.
• To assess the effectiveness of LA in patients with familial and non-familial hypercholesterolemia (FH).
• To analyze the impact of different apheresis methods on serum lipid levels.

Main Methods:

• A retrospective analysis of 250 LA procedures performed on 27 patients with dyslipidemia.
• Procedures were conducted between March 2011 and August 2019.
• Two techniques were evaluated: direct adsorption of lipoproteins (DALI) and double filtration plasmapheresis (DFPP).

Main Results:

• Significant reductions in serum total cholesterol (TC), LDL, and triglycerides were observed in all patient groups (HoFH, HeFH, non-FH).
• Double filtration plasmapheresis (DFPP) showed a significantly higher reduction in TC and LDL levels compared to direct adsorption of lipoproteins (DALI).
• The therapy was effective regardless of the apheresis technique used, with p < .001 for all significant reductions.

Conclusions:

• Lipoprotein apheresis (LA) is a highly effective treatment for reducing serum lipid levels in patients with hypercholesterolemia.
• Both DALI and DFPP techniques demonstrated significant efficacy.
• LA is a safe procedure with no major adverse events reported.