Efficacy and Safety of a New Whole‐blood Low‐density Lipoprotein Apheresis System (Liposorber D) in Severe Hypercholesterolemia

Abstract: Low‐density lipoprotein (LDL) apheresis is an extracorporeal modality to lower LDL cholesterol. While most of the devices eliminate LDL particles from plasma, a recently introduced whole‐blood perfusion column (DALI) adsorbs lipoproteins directly from whole blood. We investigated the efficacy and safety of a new whole‐blood LDL apheresis system (Liposorber D) in 10 patients with severe hypercholesterolemia in a multicenter trial. In 93 LDL aphereses, the mean reduction in LDL cholesterol and lipoprotein(a) was 62.2 ± 11.5% and 55.6 ± 16.9%, respectively ( P < 0.01). If hemodilution during apheresis was considered, the reductions were 58.0 ± 10.9 and 55.3 ± 10.9%, respectively ( P < 0.01), while high‐density lipoprotein (HDL) cholesterol did not change significantly. Three mild episodes of hypocalcemia and two mild episodes of arterial hypotension were observed; however, LDL apheresis could be continued in each case. In conclusion, the new whole‐blood LDL apheresis with Liposorber D is a safe, simple, and useful modality to reduce LDL cholesterol and lipoprotein(a) in cardiovascular high‐risk patients.