Apheresis: Applications

Essentially, four major disease groups are treated with apheresis:

  • severe fat metabolism disorders
  • Auto-immune diseases
  • Microcirculation disorders
  • Diseases in which toxins (toxins) have accumulated in the body

Treatment of lipid metabolism disorders

HELP apheresis (heparin-induced extracorporeal LDL precipitation) is a blood purification procedure that removes LDL cholesterol, lipoprotein and fibrinogen from the blood. It was developed in 1984 for the treatment of patients in whom the high concentration of blood lipid levels due to congenital disorders of the lipid metabolism can not be reduced sufficiently despite diet and medication.

Procedure: The patient is continuously drawn with a cannula blood from a vein of the arm, which is passed through a so-called plasma filter. Here, the blood cells and the blood plasma, so the non-cellular components of the blood, separated from each other. The addition of heparin causes binding of lipoprotein, LDL cholesterol or fibrinogen from the recovered blood plasma to the heparin and precipitation of the corresponding complexes (hence the name of the method: heparin-induced extracorporeal LDL precipitation; precipitation = precipitation)., These complexes are separated by means of a filter.

Subsequently, the unused heparin is removed from the purified blood plasma, so that this is restored to its normal physiological state. Through a second cannula, the patient continuously receives the separated blood cells together with the purified blood plasma during the entire treatment time. During apheresis treatment, a total of about 3, 000 ml of blood is purified. The concentration of LDL cholesterol, lipoprotein and fibrinogen is reduced by at least 60%. Treatment time depends on factors such as plasma volume and plasma flow rate and varies between 80 and 120 minutes. The flow properties of the blood are improved and the regulation of the vessel size optimized so that the blood flow in the blood vessels increases again.

Treatment of immune diseases

A disturbed balance between inflammatory and anti-inflammatory immune cells in the mucosa is the cause of Crohn's disease and ulcerative colitis, both forms of chronic intestinal inflammation. Abdominal pain and bloody diarrhea are characteristic symptoms, joints, eyes and skin may be affected by the inflammatory disease process. Studies have shown that patients with Crohn's disease and ulcerative colitis benefit particularly from apheresis, which is largely free of side effects.

Procedure: The patient is connected via an arm vein to an apheresis system. Blood is drawn continuously and the white blood cells are removed from the blood in a targeted manner. This leads to a "redistribution" of white blood cells in the body, which obviously has a positive influence on the inflammatory process. The short-term withdrawal of leukocytes does not affect the patient.

It has been found that five weekly treatments are suitable for interrupting an acute attack of intestinal inflammation and monthly therapies for remission (ie the disease does not break out again). In Japan, cell sorption was subsequently approved for the treatment of ulcerative colitis. In Germany, there is currently no valid agreement with the health insurance companies to cover the costs of treatment for Crohn's disease or ulcerative colitis. Ask your doctor if you could benefit from this treatment.

Treatment of heart muscle diseases

Also, patients who suffer from a specific heart muscle disease, it is much better after the apheresis. In idiopathic dilated cardiomyopathy (DCM), the left ventricle is dilated and therefore can pump only weak blood. The resulting heart failure (insufficiency) triggers in a kind of vicious circle a further enlargement of the heart chamber and amplifies the heart failure up to the organ failure. For the development of the DCM immunological interactions are crucial.

Implementation: The body's own antibodies, which attack the heart muscle cells, are filtered out of the patient's blood. The treatment usually lasts one week and only needs to be repeated in special cases. So far, several hundred patients with chronic heart failure have been successfully treated at the German Heart Center in Berlin.

Further applications

Although little known, there is a wide field of application for the different types of apheresis:

  • Diabetic patients.
  • Patients with age-related macular degeneration, a disease of the retina of the eye that leads to loss of central vision.
  • After a sudden onset of an acute apheresis leads to the present studies to a significant improvement, because the filtering process, the blood flow is significantly improved.
  • After severe poisoning, such as sepsis (blood poisoning with bacteria), after a fungal poisoning or severe alcohol poisoning with the help of blood washing the poison is removed from the body. In many cases, however, the reimbursement by the health insurance companies is not clarified, although the procedure is recognized in many other countries.
Share with friends

Leave your comment