Control of plasma HDL levels after plasmapheresis.

Abstract

Plasma exchange, or plasmapheresis, was first introduced for the treatment of homozygous familial hypercholesterolaemia more than 10 years ago (1), Since then it has become increasingly clear that twice monthly exchanges with plasma protein fraction (PPF) provide a safe and effective means of treating this potentially fatal condition. Several patients have undergone this regimen for over 9 years without any significant acute complications or long-term side-effects. Mean plasma cholesterol levels have been reduced to 50% of untreated values (2) and this has been accompanied by gradual disappearance of cutaneous and tendon xanthomata. However, there has been little evidence of regression of atheromatous lesions in the root of the aorta or coronary arteries, although the impression is that progression of such lesions has been arrested or slowed (3). Analysis of the life-span of 5 homozygous sibling pairs, one member of each being treated by plasma exchange and the other not, shows that this form of treatment improves the chances of survival (unpublished data).