LOS ANGELES (February 10, 2000) -- A teen-ager at Cedars-Sinai Medical Center recently became the first in the state to have their "bad" cholesterol level dramatically reduced through LDL apheresis. The patient was born with a genetic defect that had caused very high levels of LDL since birth, and at this young age, had already undergone two heart surgeries to clean out and bypass some of the major blood vessels in and around the heart.
Cedars-Sinai Medical Center is the first site in California to offer the procedure that has been developed for patients who have dangerously high levels of LDL cholesterol that do not respond to diet and drug treatment. Patients who need this therapy have genetic abnormalities that cause their "bad" cholesterol (also called LDL cholesterol) to be many times that of normal patients. Some of these patients develop heart disease so early that they may have a heart attack or need heart surgery before the age of 10.
After years of testing in the United States and other countries, LDL apheresis has been found to dramatically reduce levels of LDL -- the type of cholesterol that increases the risk of heart disease.
"The concept has existed for 20 years or so but it has become more effective and popular now because of computers and miniaturization," said Timothy A. Denton, M.D., an attending cardiologist at Cedars-Sinai and Medical Director of the LDL-Apheresis Program. "With this procedure we can reduce LDL levels very effectively."
During treatment, blood is continuously removed from a patient's vein and passed through a machine that separates red blood cells from plasma. The blood cells are returned immediately to the bloodstream through a different vein while the plasma enters a column that captures most of the LDL. The plasma is then returned to the patient without the "bad" cholesterol but with the "good" cholesterol and other vital chemicals intact.
"The procedure takes about two to four hours and must be repeated every one to three weeks, depending on the LDL level", says Dennis Goldfinger, M.D., Director of the Cedars- Sinai Transfusion Center, where the procedure is performed.
For most people, LDL cholesterol levels can be controlled through a combination of diet, exercise and drugs. This procedure is considered a potentially life-saving last resort for people whose LDL level remains very high despite taking at least two cholesterol-lowering drugs.
"With the addition of LDL apheresis, Cedars-Sinai now can provide complete therapy for every patient with hypercholesterolemia," said P.K. Shah, M.D., Director of Cardiology at Cedars-Sinai. "If a patient does not have success with diet and drugs, they could be a candidate for this unique treatment."
To determine whether LDL apheresis may be helpful and appropriate, a formal screening process is in place to review medical records and perform physical assessments of potential candidates.
Anyone interested may contact the LDL apheresis program directly at 1-800-432-7831, or can be referred by their physician.