The first results demonstrating efficiency and safety of a double-column whole blood method of LDL-apheresis
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.
aApheresis Unit, EFS (Etablissement Français du Sang), Hôpital Edouard Herriot, Lyon, France
bDepartment of Biostatistics, Centre Hospitalier Lyon Sud, HCL (Hospices Civils de Lyon), Pierre Bénite, France
cLaboratory of Lipids, Hôpital Cardiologique, HCL Bron, France
dEndocrinology Unit, Hôpital Cardiologique, HCL, Bron, 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.