Kozik-Jaromin, Justyna and Roeseler, Eberhard and Heigl, Franz and Spitthoever, Ralf and Ringel, Jens and Schmitz, Gerd and Heinzler, Rainer and Abdul-Rahman, Nadim and Leistikow, Frank and Himmelsbach, Frido and Schettler, Volker and Uhlenbusch-Koerwer, Ingrid and Ramlow, Wolfgang (2017) Safety aspects of lipidapheresis using DALI and MONET - Multicenter observational study. ATHEROSCLEROSIS SUPPLEMENTS, 30. pp. 225-231. ISSN 1567-5688, 1878-5050
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Background: Lipidapheresis was introduced for intractable hyperlipidemia as a more selective therapy than plasma exchange aiming to enhance efficacy and limit side-effects. Although this therapy is regarded safe, multicenter data from routine application are limited. We investigated direct adsorption of lipoproteins (DALI) and lipofiltration (MONET) regarding the short and the long-term safety aspects. Methods: This multicenter observational study prospectively evaluated 2154 DALI and 1297 MONET sessions of 122 patients during a period of 2 years. Safety parameters included clinical side-effects (adverse device effects, ADEs), technical complications, blood pressure and pulse rate. Also routinely performed laboratory parameters were documented. Analysis of laboratory parameters was not corrected for blood dilution. Results: Overall 0.4% DALI and 0.5% MONET treatments were affected by ADE. Technical complications occurred in 2.1% and in 0.8% DALI and MONET sessions, respectively. The most frequent ADE was hypotension, and the majority of technical problems were related to vascular access. Both types of treatments led to a drop of thrombocytes in the range of 7-8%. Hematocrit and erythrocytes decreased only during the DALI treatments by about 6%. Leucocytes decreased during the DALI therapy (similar to 15%), whereas they increased during the MONET application (similar to 11%). MONET treatment was associated with a higher reduction of proteins (fibrinogen: 58% vs. 23%, albumin: 12% vs. 7%, CRP: 33% vs. 19% for MONET and DALI, respectively). Apart from severe thrombocytopenia in two DALI patients, changes of other parameters were typically transient. Conclusions: Under routine use the frequency of side-effects was low. Still, monitoring of blood count and proteins in chronic apheresis patients is recommended. (C) 2017 Published by Elsevier Ireland Ltd.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | LOW-DENSITY-LIPOPROTEIN; THERAPEUTIC PLASMA-EXCHANGE; LONG-TERM MULTICENTER; DIRECT ADSORPTION; LDL-APHERESIS; FAMILIAL HYPERCHOLESTEROLEMIA; WHOLE-BLOOD; MANAGEMENT; COMPLICATIONS; GUIDELINES; DALI; MONET; Lipids; Apheresis |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Klinische Chemie und Laboratoriumsmedizin |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 Dec 2018 13:19 |
| Last Modified: | 14 Feb 2019 09:52 |
| URI: | https://pred.uni-regensburg.de/id/eprint/1889 |
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