Blood can be washed clean of cholesterol

by MARION McKAY, Daily Mail

Patients at risk from heart disease can now benefit from a lifesaving procedure that launders dangerously high levels of cholesterol from their bloodstream.

Lowering low-density lipoprotein (LDL) - so-called 'bad' cholesterol - is critical for people with familial hypercholesterolaemia (FH), an inherited disorder that causes a dangerous build-up of cholesterol in the blood that can lead to heart attacks.

While diet and drugs are the conventional methods of treating the condition, some individuals fail to respond and their disease can go on to be life-threatening.

Now doctors have another option called LDL apheresis, a kind of dialysis treatment that cleans the blood of the artery-clogging cholesterol.

Dr Stephanie Matthews from Llandough Hospital near Cardiff, one of just a handful of centres in Britain specialising in the treatment, is enthusiastic about it. She says: 'It does work very well. We routinely take out at least 65 per cent of the cholesterol from the bloodstream (in one session), and sometimes more, so we are dropping it very low.'

Cholesterol is a kind of white, waxy fat or lipid that occurs naturally in the body and is necessary for the production of certain hormones and other body functions.

There are two kinds. HDL, which is beneficial to us, and LDL. High levels of LDL in the bloodstream leads the body to deposit surplus in the walls of the coronary arteries and can lead to heart attacks and strokes.

LDL apheresis is used in conjunction with conventional methods to reduce the amount of LDL cholesterol as much as possible.

During the procedure, blood is continually removed from the patient's vein through a needle and run into a machine that separates the blood into plasma (fluid) and blood cells.

The plasma is then pumped through a column, which is charged to a level high enough to attract the LDL cholesterol, which is also charged. In this way, the LDL cholesterol sticks to the column like a magnet.

Once filtered, the laundered plasma and the blood cells are returned through another vein. HDL cholesterol is unaffected.

An added benefit of the treatment is that it helps reduce the stickiness of blood, making it easier to flow through constricted arteries.

The process takes about two to three hours to complete. In order for cholesterol levels to remain low, LDL apheresis needs to be repeated twice a month.

David Fisher, 57, a legal assistant who lives in Salisbury, attends Llandough Hospital every fortnight for treatment.

His heart problems began at the age of 35, when he suffered a heart attack. Seven years later he had heart bypass surgery, but doctors were still unaware of his condition.

'It was only when I started to have chest pains later on that my FH was discovered,' he says. 'I was given blood tests and doctors looked in detail at my family history. My father had died at the age of 61, and another of my relatives died when he was 23.

'It was only then that it became obvious that FH had been around for a while.'

David was given a course of medication to try to lower his cholesterol and was advised to follow a low-fat diet. For a while, his condition improved.

'Over the years, I have been on a number of lipid-lowering drugs. While I seem to tolerate them well at first, after a few months, bang, my cholesterol begins to rise again.'

Desperate to find another treatment, David discovered Dr Matthews and her pioneering work into FH. 'I knew that if I didn't get this sort of treatment, I would die,' he says.

'I usually have two needles in one arm - one taking the blood out and the other putting it back. That way, I can have one arm free. The treatment is not uncomfortable and I have no side-effects from it, though I am always very tired afterwards and my wife has to drive home.'

After each session, his cholesterol levels are measured. Normal cholesterol levels in a healthy person are under five millimoles per litre of blood.

David recalls: 'When I first started treatment, my levels were as high as 13 or 14, which is quite dangerous.

'However, for the past few treatments my levels have been around six before treatment and around one afterwards.'

Dr Matthews hopes other centres offering this treatment will be set up across the UK.

For further information, tel. 02920 716844.

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