Lipid apheresis by hemoperfusion: in vitro efficacy and ex vivo biocompatibility of a new low-density lipoprotein adsorber compatible with human whole blood

Artif Organs. 1993 Jul;17(7):640-52. doi: 10.1111/j.1525-1594.1993.tb00609.x.

Abstract

To date, selective extracorporeal low-density lipoprotein (LDL) removal can only be performed from plasma; that is, a plasma-cell separation step using a centrifuge or a plasma membrane separator is necessary initially. This article characterizes a new polyacrylate-based LDL adsorber directly applicable to whole blood. In vitro single-pass hemoperfusion tests using pooled donor blood showed quantitative adsorption of atherogenic LDL-cholesterol (LDL-C) and complete recovery of protective high-density lipoprotein C. Fibrinogen, another independent risk factor of atherosclerosis, was also adsorbed to a lesser extent. Single-pass ex vivo biocompatibility using fresh donor blood on-line was excellent and resulted in minimal cell loss. Neither signs of hemolysis nor activation of monocytes (interleukin-1 production) were detected. Only slight activation of leukocytes (elastase release) and thrombocytes (platelet factor 4 secretion) as well as of coagulation (thrombin-antithrombin complex formation) and complement (C3a, C5a generation) was observed. Under the experimental conditions used, the optimal anticoagulation regimen was 0.5 IU heparin plus 0.375 mg citrate/ml blood. Priming the column with a buffer of pH 7.4 containing heparin, citrate, and Ca2+ is recommended. In conclusion, this new adsorber exhibited selective LDL-C adsorption in vitro combined with excellent ex vivo biocompatibility and thus holds great promise for a successful clinical application in a closed-loop system in patients.

Publication types

  • Comparative Study

MeSH terms

  • Acrylic Resins
  • Adsorption
  • Biocompatible Materials*
  • Blood Coagulation / drug effects
  • Blood Component Removal / methods*
  • Citrates / pharmacology
  • Citric Acid
  • Hemoperfusion / methods*
  • Heparin / pharmacology
  • Humans
  • Lipoproteins, LDL / blood*

Substances

  • Acrylic Resins
  • Biocompatible Materials
  • Citrates
  • Lipoproteins, LDL
  • Citric Acid
  • Heparin