UNC Hospitals is first in North Carolina to offer ‘blood washing’ treatment for extremely high cholesterol

June 2, 2004

UNC Hospitals is first in North Carolina to offer ‘blood washing’ treatment for extremely high cholesterol

CHAPEL HILL, N.C. – Gary Simpson tried just about everything to lower his extremely high cholesterol levels, but nothing seemed to work.

He had heart bypass surgery at age 35. After that, he took medications for many years that helped keep his cholesterol in check. Due to side effects, he was unable to keep taking those medications, and his cholesterol levels skyrocketed. Recently, he had to have a stent placed in his heart because more blockages had formed.

Doctors consider a total cholesterol level of 200 milligrams per deciliter of blood or greater to be high enough to require medical intervention. By this standard, Simpson, a 50-year-old resident of Fayetteville, N.C., was way off the chart. He had a total cholesterol level that exceeded 300 milligrams per deciliter of blood, and his LDL or “bad” cholesterol level alone, at 260, far outweighed his HDL or “good” cholesterol level.

Then, about six months ago, he started a new treatment at UNC Hospitals, called LDL apheresis. In this procedure, the patient is connected to a machine that removes or “washes” excess levels of low-density lipoprotein (LDL cholesterol) out of the blood, and then returns the cleaned blood to the patient. Patients receive the treatment, which lasts 2-3 hours and lowers LDL levels by up to 83 percent, once every two weeks. It’s similar to an older procedure called plasma-exchange, which filtered both LDL and HDL, but LDL apheresis offers the advantage of filtering out LDL only while leaving the patient’s HDL (“good” cholesterol) level unchanged.

Before starting on LDL apheresis, Simpson said, he generally felt bad all the time. He had trouble breathing, couldn’t do simple yard work around his home, and was afraid to go anywhere because of his condition.

Now, “I feel a lot better than I did before,” he said. “I’m doing things now that I couldn’t do before.”

Simpson is typical of the type of patient who can benefit from LDL apheresis, said Dr. Ross J. Simpson, a professor in the UNC School of Medicine’s division of cardiology, who is not related to Gary Simpson, the patient.

“LDL apheresis is a very effective treatment for patients whose cholesterol levels are extremely high, often because of a genetic predisposition, and for whom no other treatments have helped,” Dr. Simpson said. “In patients with a family history of extremely high cholesterol, studies show that apheresis reduces coronary events, such as a heart attack, by 72 percent. So apheresis doesn’t just lower cholesterol; it is literally life-saving.”

But LDL apheresis is not for everybody. To be considered eligible for LDL apheresis, notes Julie Ruch, a nurse practitioner and director of the UNC Heart Center’s Lipid Clinic, patients without existing heart disease must have an LDL level greater than 300 milligrams per deciliter and be on maximum drug therapy or unable to tolerate drug therapy. Patients who do have documented heart disease and are on maximum drug therapy or cannot tolerate drug therapy must have an LDL level greater than 200 milligrams per deciliter to be eligible for LDL apheresis.

The machine used in the treatment, called the Liposorber system, is sold by Kaneka Pharma America Corp., which is based in New York City. Liposorber treatment is available in only a small number of medical centers nationwide, and UNC Hospitals is the only provider in North Carolina that offers it. Previously, the closest centers for this treatment were in Baltimore, Md., and Charleston, S.C.

The UNC Lipid Clinic is currently screening patients for enrollment into the program. To request an appointment, call (919) 966-7244. Additional information about LDL apheresis is available at the UNC Heart Center’s Web site, www.uncheartcenter.org.

Media contact: Stephanie Crayton-Robinson, (919) 966-2860, scrayton@unch.unc.edu