The first results demonstrating efficiency and safety of a double-column whole blood method of LDL-apheresis

Hequet, O.; Le, Q.H.; Rigal, D.; Mekhloufi, F.; Jaeger, S.; Sassolas, A.; Groisne, L.; Moulin, P.

doi:10.1016/j.transci.2009.10.001

« Previous Next »Transfusion and Apheresis Science
Volume 42, Issue 1 , Pages 3-10, February 2010

The first results demonstrating efficiency and safety of a double-column whole blood method of LDL-apheresis

O. Hequet
- Apheresis Unit, EFS (Etablissement Français du Sang), Hôpital Edouard Herriot, Lyon, France
- Corresponding author. Address: Centre de santé, Etablissement Français du Sang (EFS), Pavillon I, Hospital Edouard Herriot, 5 place d’Arsonval, 69003 Lyon, France. Tel.: +33 4 72 68 46 39; fax: +33 4 72 68 46 40.
Q.H. Le
- Department of Biostatistics, Centre Hospitalier Lyon Sud, HCL (Hospices Civils de Lyon), Pierre Bénite, France
D. Rigal
- Apheresis Unit, EFS (Etablissement Français du Sang), Hôpital Edouard Herriot, Lyon, France
F. Mekhloufi
- Apheresis Unit, EFS (Etablissement Français du Sang), Hôpital Edouard Herriot, Lyon, France
S. Jaeger
- Apheresis Unit, EFS (Etablissement Français du Sang), Hôpital Edouard Herriot, Lyon, France
A. Sassolas
- Laboratory of Lipids, Hôpital Cardiologique, HCL Bron, France
L. Groisne
- Endocrinology Unit, Hôpital Cardiologique, HCL, Bron, France
P. Moulin
- Endocrinology Unit, Hôpital Cardiologique, HCL, Bron, France

Received 27 October 2008; accepted 25 August 2009.

Abstract

LDL-apheresis is a treatment for familial hypercholesterolemia in addition to diet and drug therapy. In the past, LDL-apheresis techniques consisted in separating plasma from blood and adsorbing plasma LDL-C whereas recent methods remove LDL-C directly from whole blood. The whole blood system developed by Kaneka consists of a single-column (Liposorber DL-75) treatment (SCWB) but a double-column whole blood (DCWB) method has recently been developed (Liposorber DL-50×2).

When 1.6 blood volumes (plus 1l) were processed, acute reductions of total cholesterol and LDL-C were 67.9±6% and 80.2±4.5%, respectively. The performances of the DCWB method were compared to other LDL-apheresis methods. Assessed in 10 patients, the DCWB method is more efficient than the SCWB method with higher reduction rates of LDL-C (79.7±4.9 vs. 68.2±5.0% p<0.0001) and apolipoprotein-B (79.5±5.4 vs. 67.4±5.4% p<0.0001). In a sub group of five patients having the highest LDL-C baseline levels, the LDL-C reduction rates obtained by the DCWB method are equivalent to those obtained by the conventional LDL-apheresis method consisting of preliminary plasma separation followed by plasma LDL-C adsorption and used as first line apheresis therapy (80.5±4.5 vs. 79.0±5.9%). The safety of DCWB was demonstrated in 12 patients with only a low frequency of mild and transient adverse effects (4%).

In conclusion, the DCWB LDL-apheresis method provides efficient removal of LDL-C, a low level of adverse effects, and a shortened duration of the procedure.

Keywords: LDL-apheresis, Whole Blood method, Adsorption of lipoproteins, LDL-C