Low-density lipoprotein apheresis for the treatment of refractory hyperlipidemia

Adrian Vella, Alvaro A. Pineda, Timothy O’brien

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


The advent of treatment with 3-hydroxy-3-methylglutaryl coenzyme A inhibitors has meant that, with a combination of diet and drug therapy, adequate control of serum cholesterol concentrations can be achieved in most patients with hypercholesterolemia. However, some patients, primarily those with familial hypercholesterolemia (FH), may require additional therapy to lower their cholesterol levels. In recent years, low-density lipoprotein (LDL) apheresis has emerged as an effective method of treatment in these patients. The criteria for commencement of LDL apheresis are LDL cholesterol levels of 500 mg/dL or higher for homozygous FH patients, 300 mg/dL or higher for heterozygous FH patients in whom medical therapy has failed, and 200 mg/dL or higher for heterozygous FH patients with documented coronary disease and in whom medical therapy has failed. In addition to cholesterol lowering in patients with FH, other indications for LDL apheresis are emerging. These include its use in the treatment of graft vascular disease in patients receiving cardiac transplants as well as in the treatment of certain glomerulonephritides. This review examines the role of LDL apheresis in the management of lipid disorders and the evidence available to support its use in clinical practice.

Original languageEnglish (US)
Article number62489
Pages (from-to)1039-1046
Number of pages8
JournalMayo Clinic proceedings
Issue number10
StatePublished - Oct 2001


  • ACEI = angiotensin-converting enzyme inhibitor
  • Apo B = apolipoprotein B
  • DFPP = double-filtration plasmapheresis
  • FH = familial hypercholesterolemia
  • HDL = high-density lipoprotein
  • HELP = heparin extracorporeal LDL precipitation
  • HMG-CoA = 3-hydroxy-3-methylglutaryl coenzyme A
  • LDL = low-density lipoprotein
  • NCEP = National Cholesterol Education Program

ASJC Scopus subject areas

  • Medicine(all)


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