Lipoprotein Apheresis – Own Experience

Author(s):

Marta Hreńczuk*, Tomasz Piątek and Piotr Małkowski

Low density lipoprotein (LDL) apheresis is utilized in clinical practice with patients suffering from lipid disorders with a high and very high cardiovascular risk. One treatment allows to reduce the concentration of LDL by 55 – 80%. These treatments are recommended primarily for patients with a familial homozygous hypercholesterolemia, for whom treatments should be commenced as early as at the age of 5-8 years old. Therapy is also used for patients with a heterozygous form of hypercholesterolemia if, despite maximum doses of statins, further progress of clinically symptomatic atherosclerosis is observed. Apheresis is recommended when, despite a diet and maximum tolerable pharmacotherapy, the concentration of LDL is ≥ 300 mg/dl (7,7 mmol/l) or ≥ 200 mg/dl (5,2 mmol/l) throughout 6 months for patients with documented coronary heart disease. In recent years an indication to perform apheresis is also an isolated increase of lipoprotein (a), with values >60 mg/dl. The apheresis treatment lasts 2-3 hours and must be repeated every 1-2 weeks for the rest of the patient’s life, it is safe and not associated with dangerous complications. Below we present the current state of knowledge regarding LA with a description of own experience.