Treatment of Hyperlipidemia With a Modified Low Density Lipoprotein Apheresis System With Dextran Sulfate

Abstract

Many low density lipoprotein (LDL) apheresis systems have been applied to patients with hyperlipidemia, but these systems usually work on the basis of complicated equipment and the cost of treatment is expensive. In order to achieve effective treatment of hyperlipidemia at a lower cost, we developed a new LDL apheresis system with dextran sulfate (LAS-DS). In this study, 50 patients with hyperlipidemia were treated 120 times with the new LAS-DS. In each treatment, 600 +/- 100 mL of plasma (equal to approximately 25% of the total plasma of patients) was collected by apheresis, and DS solution and calcium chloride solution were added into the collected plasma as LDL absorber and catalyzer, respectively. DS selectively binds LDL cholesterol (LDL-C) under the catalysis of calcium ion and the LDL-C-DS complex is removed by centrifugation. The treated plasma was transfused back into the patients and the excessive calcium in the plasma was removed by the cation exchange column integrated in the transfusion set. After treatment with our new system, the acute mean LDL-C reduction was 97% in the apheresis plasma of hyperlipidemia patients. The corresponding reduction was 55.2% and 69.4% for total cholesterol and total triglyceride. There were insignificant reductions of high density lipoprotein cholesterol (HDL-C) and albumin. The new LDL apheresis system with DS that we developed is very simple to operate without relying on complicated equipment, and it can achieve significant clinical results at a much lower cost compared with existing systems. Based on this study we think the new system can provide a safe, effective and much cheaper means for the treatment of hyperlipidemia patients.

A heparin modified polypropylene non‐woven fabric membrane adsorbent for selective removal of low density lipoprotein from plasma

“…LDL‐apheresis, however, has been proven to be useful and powerful in treating FH patients and those who cannot be sufficiently treated by diet and drugs . LDL apheresis is a technique of extracorporeal lipoprotein elimination of pathologically accumulated LDL‐C . The key to this technique is to look for good adsorbents with excellent adsorption capacity, high selectivity, good hemocompatibility and biocompatibility, adequate mechanical and physical properties, low‐price, and without toxicity.…”

Low‐density Lipoprotein Apheresis: Plasma Exchange or Dextran Sulfate Adsorption Apheresis

“…The article entitled “Treatment of Hyperlipidemia with a Modified Low Density Lipoprotein Apheresis System with Dextran Sulfate” written by Zhao et al. and published in one of the recent issues of your journal was quite interesting (1). Low‐density lipoprotein (LDL) apheresis is commonly performed by three techniques: plasma exchange (plasmapheresis), dextran sulfate adsorption, and heparin mediated extracorporeal LDL precipitation.…”