LDL-apheresis therapy: techniques and indications

A severe disease: Homozygote hypercholestrolemia is a very severe disease w ith an extremely high atherogenic potential. The risk of sudden death start s at about the age of 10 years and mortality reaches nearly 100% at 20 year s. In this homozygote autosomal dominant disorder, serum cholesterol rises above 6 g/l due to a total deficiency of LDL-receptors. LDL-apheresis: The treatment of choice, LDL-apheresis, is an aggressive tre atment Drug regimens and palliative surgery have little or no effect. Liver transplantation is highly effective but compromises long term prognosis. L DL-apheresis, indicated in case of drug resistance, can be used to clear at herogenic LDL particles extracorporally. Currently it is the most effective means of lowering serum cholesterol in these patients and avoid potential cardiovascular complications. Several techniques: The most specific techniques are also the most costly T hese techniques allow treating whole blood or previously separated plasma. Such specific techniques are indicated in children. Compared with other Eur opean countries such as Germany, the development of these techniques has be en retarded in France due to the lack of financing by the national health i nsurance system.