Information About the Field of LDL apheresis
What is apheresis?
Apheresis involves the removal of particular constituents of the blood through a device that is connected to the patients veins.
The component of the blood that is extracted can vary. Apheresis can for instance be used to extract pure blood plasma or specific desired blood cells of a healthy patient, in order to treat another patient with it. However, apheresis may also be therapeutic for the patient as harmful substances can be removed from the blood (e.g. fat or LDL cholesterol).
Which diseases can be treated by lipid apheresis?
The main therapeutic indication for lipid apheresis is the presence of familial hypercholesterolemia. This disorder fat metabolism is associated with elevated cholesterol levels which can lead to the formation of deposits in the blood vessels (arteriosclerosis) and therefore lead to an increased risk of heart attack at an early stage.
Patients with familial hypercholesterolemia should maintain a strict diet and take medication to prevent said complication. Lipid apheresis may in turn be useful, if this therapeutic approach is not sufficient.
Process and duration of lipid apheresis
Lipid apheresis takes approximately 2-3 hours and can be carried out in an outpatient clinic or practice. In other words, the patient does not have to stay in the hospital, but is simply placed on a bed and connected to the apheresis device through needles in the arm veins and a tube system. Follwoing this, the patients blood is collected, pumped into the machine, cleaned and returned to the patients' circulation.
The procedure is quite straightforward for the patient and, apart from the needle puncture will not cause any pain.
To ensure therapeutic success, the procedure requires regular sittings (for instance 1-2 times per week).
What risks and unwanted side effects have to be considered?
There are only few risks and side effects. Local irritation at the puncture site in the vein may develop or a small hematoma may form. Basically any injection site has the potential to become infected, but the risk of this complication can be minimized and is extremely rare.
Some patients may develop a reaction of the circulation. This includes blood pressure drops, the patient may feel sick or cold and is pale and dizzy.
Meeting the costs for apheresis
Given that lipid apheresis is a costly therapeutic modality, other treatment methods must be thoroughly explored before the physician can consider apheresis as an appropriate treatment option.
Should this be the case, patients have to apply to the respective health insurance company for coverage of the costs (this is valid for one year at first, then a new application has to be made).
Which doctors and clinics perform lipid apheresis?
Blood purification procedures including apheresis are usually performed by specialists in internal medicine who have a focus on nephrology.
In Germany, a number of apheresis centers are specialized in this field.
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