Cascade Filtration for Familial Hypercholesterolemia

Valbonesi, M; Bigi, Leonardo; Ferrari, Mauro; Florio, Gaetano

doi:10.1177/039139889101401201

Cited by 11 publications

(1 citation statement)

References 6 publications

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“…Elimination of lipoproteins in the study is largely comparable to already published investigations with a tendency toward higher LDL elimination rates accompanied by less removal of HDL (16,18,20,21,23–25). In the light of the present data, MDF configurations with HDL elimination rates up to 35% to 40% are not suitable for the purpose of LDL elimination (26).…”

Section: Discussionsupporting

confidence: 83%

Comparison of Two Filter Combinations for Low‐Density Lipoprotein Apheresis by Membrane Differential Filtration: A Prospective Crossover Controlled Clinical Study

Matic¹,

Kohlschein

Wallstab³

et al. 2002

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Membrane differential filtration is an accepted procedure for the extracorporeal removal of low-density lipoprotein (LDL). Reduction rates largely depend on the nature of the membranes and are ideally evaluated in a crossover study design. Four patients who had been treated by LDL apheresis for at least 6 months were included. Six consecutive weekly sessions (40 ml plasma/kg body weight) were scheduled per system (Plasmacure PS06/Evaflux Eval 5A [Kuraray] versus Plasmaflo OP05W/Cascadeflo AC1770 [Asahi]). Laboratory measurements indicated reductions of plasma concentrations for fibrinogen (37% [Kuraray] versus 44% [Asahi]), IgG (15% versus 20%), IgA (24% versus 28%), IgM (63% versus 53%), and total protein (11% versus 16%). Total cholesterol was eliminated by 52% versus 49%, LDL by 67% versus 66%, triglycerides by 56% versus 41%, and high-density lipoprotein by 10% versus 20%. Three therapies employing the Asahi filter combination were terminated prematurely due to saturation of the plasma fractionator. In conclusion, despite similar physical properties, the membranes differ significantly concerning selectivity and sensitivity to saturation.

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Section: Discussionsupporting

confidence: 83%

Comparison of Two Filter Combinations for Low‐Density Lipoprotein Apheresis by Membrane Differential Filtration: A Prospective Crossover Controlled Clinical Study

Matic¹,

Kohlschein

Wallstab³

et al. 2002

Artificial Organs

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Effectiveness of cascade filtration plasmapheresis in two patients affected by familial hypercholesterolemia

Barbagallo

Averna

Dimarco

et al. 1995

J of Clinical Apheresis

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Hypercholesterolemia has been recognised as a primary risk factor for coronary heart disease. Reduction of plasma levels of total and LDL cholesterol has been shown to decrease coronary atherosclerosis. Plasmapheresis represents an useful non-pharmacological tool to treat severe hypercholesterolemias. We have evaluated the effectiveness of a system of plasmapheresis using a cascade filtration method in two young male subjects (aged 16 and 26 years) with homozygous familial hypercholesterolemia. Both showed severe coronary atherosclerosis as determined by angiography. Procedures were performed at intervals of 7 days in each case. We observed a mean reduction of plasma levels of total cholesterol of 59.5% (range 31.0-75.5%); LDL-cholesterol, 61.6% (range 32.6-77.1%); triglycerides, 48.1%; HDL-cholesterol, 31.1%; apo A-I, 30.8%; and apo B, 57.6%. We also noted a reduction of other parameters, such as fibrinogen (49.9%) and Lp(a) (59.9%). At the end of each procedure about 8 g of cholesterol was removed from the total body pool. A decrease of total proteins (26.9%) and albumin (19.6%) was also observed, but this was completely restored before the next apheresis (1 week). These data show the effectiveness of the removal of LDL in a cascade filtration system, which obtains results not very different from other more selective methods. The lack of selectivity is not much of a problem, since it also reduces other risk factors such as Lp(a) and fibrinogen.

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