Summary
The first clinical application of a new extracorporeal procedure (HELP) for the selective elimination of low-density lipoproteins by heparin precipitation at acid pH is described. Plasma, obtained by filtration of whole blood through a 0.2 µ filter, is continuously mixed with an equal volume of an acetate buffer (pH 4.85) containing heparin. After removal of the precipitated heparin complex by filtration, excess heparin is adsorbed to a specially developed filter and the clear plasma filtrate is subject to bicarbonate dialysis/ultrafiltration to restore physiologic pH and remove excess fluid. The calculated efficiency for the elimination of low-density lipoproteins from plasma by HELP is 100% and is therefore comparable to conventional plasmapheresis. The HELP system shows a high degree of specificity with over 80% of total protein being returned to the patient. Over 130 treatment procedures have now been performed. Patient compliance and acceptance have been excellent and no major complications have been observed.
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Abbreviations
- AT III:
-
Antithrombin III
- HDL:
-
High density lipoproteins
- HELP:
-
Heparin extracorporeal LDL precipitation
- LDL:
-
Low density lipoproteins
- VLDL:
-
Very low density lipoproteins
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Eisenhauer, T., Armstrong, V.W., Wieland, H. et al. Selective removal of low density lipoproteins (LDL) by precipitation at low pH: First clinical application of the HELP system. Klin Wochenschr 65, 161–168 (1987). https://doi.org/10.1007/BF01728226
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DOI: https://doi.org/10.1007/BF01728226