Selective Continuous Extracorporeal Elimination of Low-Density Lipoproteins from Plasma by Heparin Precipitation without Cations

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Abstract
An extracorporeal procedure is described for the selective removal of LDL from patients with familial hypercholesterolemia. It comprises plasmapheresis followed by selective precipitation of LDL from plasma with heparin at low pH. The LDL-heparin complex is then removed by filtration and the clear plasmafiltrate subjected to bicarbonate dialysis to restore physiological pH and maintain fluid and electrolyte balance. The capacity and efficiency of the system for the selective elimiation of LDL was confirmed by in vitro studies with three liters of plasma from a hypercholesterolemic patient. Extensive animal investigations have demonstrated the applicability and biocompatibility of the procedure. This has been further confirmed by a first application in a human volunteer.

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