LDL Apheresis
LDL Apheresis
What is LDL apheresis?
LDL (low-density lipoprotein) apheresis is an FDA-approved treatment option for patients with high LDL cholesterol (LDL-C). It removes unwanted LDL cholesterol from blood. A machine is used to pump the patient's blood through a filter that selectively removes harmful lipid particles. The removed particles include LDL, LP(a), and triglycerides. The filter does not remove the good (HDL) particles from the patients’ blood.
In our center, the patient's blood is separated into cells and plasma. The plasma is run over a material that binds the harmful particles and is then returned to the patient. One downside of this process is that it requires us not to use ace inhibitor drugs, like lisinopril, because these increase the risk of adverse reactions.
Background
LDL cholesterol (LDL-C) level is one of the major risk factors causing atherosclerosis or plaque in the arteries that can result in coronary artery disease, strokes and peripheral artery disease in the abdomen and legs.
Traditional treatments for high LDL-C are a low-fat diet and medications such as the statins alone (generic names of statins: atorvastatin, rosuvastatin, simvastatin, pravastatin, fluvastatin and lovastatin) or in combination with non-statin drugs (injectable PCSK-antibody such as Evolocumab, Alirocomab, and Inclisiran; bempedoic acid, colesevelam, and niacin). However, for some, even combination therapies may not be enough, especially for those with a family history of high cholesterol or premature heart disease.
Our Approach
University of Michigan Health is one of the few centers in the U.S. to perform LDL apheresis. The procedure is performed in the University Hospital Transfusion and Apheresis Service center. Cardiovascular Medicine and Pathology work together to offer this procedure. Eligible patients who choose LDL apheresis are followed by our lipid specialists to assure safety, requirements for medications, and desired treatment targets.
Recommended For
LDL apheresis is indicated for the following individuals for whom diet and maximum drug therapy has either been ineffective or not tolerated:
Familial hypercholesterolemia with LDL-C >300 mg/dl
Familial hypercholesterolemia with cardiovascular risk factors and LDL-C > 200 mg/dl
Familial hypercholesterolemia with LDL-C > 160 mg/dl w/ coronary or peripheral arterial disease
Patients with a history of coronary or peripheral vascular disease and an LDL-C > 100 mg/dl and Lp(a) > 60 mg/dl
FAQ
How often is LDL apheresis done and how long does the procedure take?
Individuals undergoing LDL apheresis go to the Transfusion and Apheresis Service in the University Hospital every two weeks or as indicated by the lipid specialists. The procedure takes approximately 2 to 3 hours to complete.
Who is blood accessed for the procedure?
The use of LDL apheresis requires withdrawing of blood from a vein or artery and returning it to the circulation using a separate vein. This can be done through use of 2 veins on each occasion, creating an arterial-venous connection in the arm like that used for kidney dialysis, or a port using the inner side of the upper right arm or the upper right chest.
How effective is LDL Apheresis?
With over 20 years of worldwide experience on more than 2,500 patients and 250,000 tests, the safety and effectiveness of LDL apheresis is well known. There is a low incidence of adverse events (most commonly low blood pressure), or problems with the access site. The reduction in LDL cholesterol has been shown to reduce heart attacks and the progression of coronary disease, as well as improve vascular function.
The research has shown that with LDL apheresis, LDL cholesterol can be reduced by up to 80 percent but is back to pre-apheresis levels in 2 weeks in most persons with LDL-C >190mg/dl and 1 week if LDL-C is over 240mg/dl.
What is the cost of LDL Apheresis?
Most insurance carriers cover the cost of LDL apheresis, which is approximately $2500 per treatment. We will work with you and your insurance company to determine your coverage for this procedure. For more information about the LDL apheresis procedure call the Transfusion and Apheresis Service at 734-936-6900.
Appointment Information
Our Lipid Management Program's expert team will evaluate whether LDL apheresis is right for you. The team specializes in the evaluation, treatment and management of lipid disorders. Through their evaluation they will determine your best treatment options.
To find out more information or to set up an appointment for a Lipid Management consultation, call 888-287-1082 or visit the Make a Cardiovascular Appointment page.
Resources
Locations
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Apheresis Procedure Unit | Med Inn Building 1500 E Medical Center Dr
Floor 2 Room F225
Ann Arbor, MI 48109Get Directions
Doctors
John David Bisognano, MD, PhD
Clinical Professor
Cardiovascular Disease, Advanced Heart Failure & Transplant Cardiology, Internal Medicine, Cardiology
Eric Jerome Brandt, MD, MHS, FACC
Assistant Professor
Cardiovascular Disease, Internal Medicine
Kent Brummel, MD, FACC
Clinical Assistant Professor
Cardiovascular Disease, Internal Medicine
Geoffrey Colin Williams, MD
Clinical Professor
Internal Medicine
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