Transfusion and Apheresis Science
Volume 35, Issue 2 , Pages 103-110, October 2006

Heparin-mediated extracorporeal low density lipoprotein precipitation as a possible therapeutic approach in preeclampsia

  • Ying Wang

      Affiliations

    • Institute of Clinical Chemistry, University Hospital Grosshadern, Marchioninistrasse 15, 81377 Munich, Germany
    • Corresponding Author InformationCorresponding author. Tel.: +49 89 7095 3239; fax: +49 7731 181112.
    • ,
  • Autar K. Walli

      Affiliations

    • Institute of Clinical Chemistry, University Hospital Grosshadern, Marchioninistrasse 15, 81377 Munich, Germany
    • ,
  • Andreas Schulze

      Affiliations

    • Division of Neonatology, Klinikum Grosshadern, University of Munich, Germany
    • ,
  • Frithjof Blessing

      Affiliations

    • Institute of Clinical Chemistry, University Hospital Grosshadern, Marchioninistrasse 15, 81377 Munich, Germany
    • ,
  • Peter Fraunberger

      Affiliations

    • Institute of Clinical Chemistry, University Hospital Grosshadern, Marchioninistrasse 15, 81377 Munich, Germany
    • ,
  • Christian Thaler

      Affiliations

    • Division of Obstetrics and Gynaecology, Klinikum Grosshadern, University of Munich, Germany
    • ,
  • Dietrich Seidel

      Affiliations

    • Institute of Clinical Chemistry, University Hospital Grosshadern, Marchioninistrasse 15, 81377 Munich, Germany
    • ,
  • Uwe Hasbargen

      Affiliations

    • Division of Obstetrics and Gynaecology, Klinikum Grosshadern, University of Munich, Germany

Received 3 November 2005; received in revised form 29 April 2006; accepted 18 May 2006.

Abstract 

Preeclampsia is a pregnancy-related hypertensive disease resulting in substantial maternal and neonatal morbidity and mortality. Until today there is no satisfactory treatment to stop disease progression except immediate delivery of the fetus. Heparin-mediated extracorporeal low density lipoprotein (LDL) precipitation (H.E.L.P.) apheresis removes simultaneously circulating LDL, lipoprotein(a) [Lp(a)], fibrinogen, C-reactive protein (CRP) and various proinflammatory and procoagulatory factors. This study was to test the feasibility of H.E.L.P. apheresis in preeclamptic patients and its potential effects on blood and placental markers of preeclampsia. We applied H.E.L.P. apheresis to nine preeclamptic patients and it was well tolerated. Their gestational ages could be continued by 17.7 (3–49) more days. Eight of the nine neonates did well during their neonatal stage. One infant died of late-onset sepsis. H.E.L.P. apheresis reduced significantly circulating levels of triglycerides, total and LDL-cholesterol, Lp(a), fibrinogen, hs-CRP, TNFα, sVCAM-1, E-selectin, lipopolysaccharide binding protein (LBP), homocysteine and plasma viscosity. We conclude that H.E.L.P. apheresis reduced maternal circulating levels of proinflammatory and coagulatory markers and plasma viscosity without overt maternal or neonatal clinical side effects.

Keywords: Preeclampsia, Heparin-mediated extracorporeal low density lipoprotein precipitation (H.E.L.P.) apheresis, Endothelial dysfunction, Inflammation, Coagulation

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PII: S1473-0502(06)00115-7

doi:10.1016/j.transci.2006.05.010

Transfusion and Apheresis Science
Volume 35, Issue 2 , Pages 103-110, October 2006

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