What is Apheresis?

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If you have FH, particularly if you have homozygous FH inherited from both parents, do not respond to regular medical treatment, or suffer from side effects of other treatments, one of the options that may be recommended to you is something you’ve probably never heard of: apheresis. This unusual-sounding word can actually help you understand the treatment conceptually. It comes from the Greek for “take away.” That is exactly what is done during the treatment: your blood is taken away from your body and the LDL cholesterol is removed, something FH prevents the body from doing on its own.

How Apheresis Works

When you get this treatment for FH, blood is first removed from the body. Using one of several techniques, doctors then remove LDL from that blood before returning it to the body. Apheresis has been adopted by doctors who treat FH because it provides a safe and effective way to treat patients who are at a high risk of severe cardiovascular diseases and events. By replacing the body’s natural mechanisms for removing LDL that are altered by FH, this treatment can help FH patients maintain lipid balances in the blood that are much closer to normal levels. It must be completed at regular, frequent intervals in order to achieve success over time.

When FH Patients Should Get Apheresis

Ideally, this treatment should be started as soon as possible. Published guidelines suggest that this type of blood “cleaning” should be started before the age of seven for patients who have homozygous FH, or FH that was inherited from both parents, because they have a significantly shorter life expectancy without it.  Until now, homozygous FH has nearly always be treated in this way.  For heterozygous FH patients, the need for apheresis is somewhat less dire, but it may be suggested if lifestyle changes and drug therapy are failing to reduce cholesterol levels to an appropriately low level of risk.

Goals of External LDL Removal

This treatment for FH typically occurs at weekly or biweekly intervals over an extended period of time.  At minimum, the goals are a 65% reduction of total cholesterol or 70% reduction in LDL during each procedure, and a baseline reduction of 50% total cholesterol or 55% LDL over the course of treatment as compared to the baseline levels measured without the treatment. The goal is to exceed these minimum success requirements by as much as possible. Though this treatment is a very serious commitment, these results show just how much it can benefit FH patients.

If you or a loved one is suffering from the FH genetic disorder, The FH Foundation is here to provide the resources you need to understand and manage the disease. We are the only organization in the United Statesdedicated to raising awareness of FH. For more information, or to find out how you can get involved, contact us today.

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