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Titolo:
DALI apheresis in hyperlipidemic patients: Biocompatibility, efficacy, andselectivity of direct adsorption of lipoproteins from whole blood
Autore:
Bosch, T; Lennertz, A; Schmidt, B; Fink, E; Keller, C; Toepfer, M; Drager, J; Samtleben, W;
Indirizzi:
Univ Munich, Klinikum Grosshadern, Med Klin 1, Div Nephrol, D-81366 Munich, Germany Univ Munich Munich Germany D-81366 Div Nephrol, D-81366 Munich, Germany Univ Munich, Inst Clin Chem & Biochem, D-81366 Munich, Germany Univ Munich Munich Germany D-81366 em & Biochem, D-81366 Munich, Germany Univ Munich, Klinikum Innenstadt, Med Poliklin, D-81366 Munich, Germany Univ Munich Munich Germany D-81366 Med Poliklin, D-81366 Munich, Germany Dialysis Ctr, Murnau, Germany Dialysis Ctr Murnau GermanyDialysis Ctr, Murnau, Germany Univ Appl Sci, Stralsund, Germany Univ Appl Sci Stralsund GermanyUniv Appl Sci, Stralsund, Germany
Titolo Testata:
ARTIFICIAL ORGANS
fascicolo: 2, volume: 24, anno: 2000,
pagine: 81 - 90
SICI:
0160-564X(200002)24:2<81:DAIHPB>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
LDL-APHERESIS; LIPID APHERESIS; DEXTRAN-SULFATE; ANAPHYLACTOID REACTIONS; ACE INHIBITORS; HEMOPERFUSION; DISEASE; HEMODIALYSIS; CHOLESTEROL; FIBRINOGEN;
Keywords:
LDL-apheresis; direct adsorption of lipoproteins; biocompatibility; bradykinin; lipoprotein(a); LDL-hemoperfusion;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Bosch, T Univ Munich, Klinikum Grosshadern, Med Klin 1, Div Nephrol, D-81366 Munich, Germany Univ Munich Munich Germany D-81366 rol, D-81366 Munich, Germany
Citazione:
T. Bosch et al., "DALI apheresis in hyperlipidemic patients: Biocompatibility, efficacy, andselectivity of direct adsorption of lipoproteins from whole blood", ARTIF ORGAN, 24(2), 2000, pp. 81-90

Abstract

Recently, the first apheresis technique for direct adsorption of low-density lipoprotein (LDL) and lipoprotein (a) [Lp(a)] from whole blood (DALI) was developed that does not require a prior plasma separation. That markedly simplifies the extracorporeal circuit. The aim of the present study was to test the acute biocompatibility, efficacy, and selectivity of DALI apheresis. In a prospective clinical study, 6 hypercholesterolemic patients suffering from angiographically proven atherosclerosis were treated 4 times each by DALI. 1.3 patient blood volumes were treated per session at blood flow rates of 60-80 ml/min using 750 or 1,000 ml of polyacrylate/polyacrylamide adsorber gel. The anticoagulation consisted of an initial heparin bolus followed by a citrate infusion. The sessions were clinically essentially uneventful. Mean corrected reductions of lipoproteins amounted to 65% for LDL-cholesterol, 54% for Lp(a), 28% for triglycerides, 1% for HDL-cholesterol, and 8% for fibrinogen. The selectivity of lipoprotein removal was high. Cell counts remained virtually unchanged and no signs of hemolysis or clotting were detected. Cell activation parameters elastase, beta-thromboglobulin, interleukin-1 beta, and IL-6 showed no significant increase. Complement activation was negligible. There was significant, but clinically asymptomatic, bradykinin activation in the adsorber with mean maxima of 12,000 pg/ml in the efferent line at 1,000 mi of treated blood volume. In conclusion, DALI proved to be safe, selective, and efficient for the adsorption of LDL-C and Lp(a), which simplifies substantially the extracorporeal therapy in hypercholesterolemic patients.

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Documento generato il 20/01/21 alle ore 12:26:04