State of the art of lipid apheresis

被引:23
作者
Bosch, T
机构
[1] Klinikum Grosshadern, University of Munich, Munich, Germany
[2] Nephrological Department, Medical Clinic I, University of Munich, D-81377 Munich, Germany
关键词
lipid apheresis; plasma exchange; double filtration; dextran sulfate; immunoadsorption; heparin-induced LDL precipitation; low-density lipoprotein cholesterol; lipoprotein (a); LDL hemoperfusion;
D O I
10.1111/j.1525-1594.1996.tb04447.x
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
Currently, 5 different lipid apheresis procedures are available for routine clinical treatment of hypercholesterolemic patients. Unselective plasma exchange is a technically simple extracorporeal circuit, but albumin substitution fluid must be used and there is no high-density lipoprotein (HDL) recovery. Semiselective double filtration with improved size selectivity because of a small-pore secondary filter combines good elimination of low-density lipoprotein (LDL), lipoprotein (a) (Lp[a]), and fibrinogen with adequate HDL recovery; modifications such as thermofiltration, predilution/backflush, or pulsatile flow have been proposed for the improvement of this system. Three highly selective procedures are based on immunologic or electrostatic interactions: immunoadsorption using anti-low-density lipoprotein (LDL) antibodies, chemoadsorption onto dextran sulfate, and heparin-induced LDL precipitation (HELP) apheresis. The features of each system are discussed critically. Lastly, two new developments, Lp(a) immunoadsorption and LDL hemoperfusion using a polyacrylate LDL adsorber compatible with whole blood, are described.
引用
收藏
页码:292 / 295
页数:4
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