The Dresden Apheresis Center - experience with LDL apheresis and immunoadsorption

Abstract

The first apheresis center in former German Democratic Republic was established in Dresden November 1990 following the reunification of Germany. We here summarize the activities of this center to date. From the center's establishment until the end of July 2009 13,291 sessions of therapeutic apheresis have been performed. Four LDL apheresis methods, namely DALI, Therasorb LDL, HELP and lipidfiltration, are available and several comparative studies of these methods have been published. In addition, we have established the Therasorb IG method and two rheophoresis methods (Rheofilter SR 20; TheraSorb-Rheo Adsorber). Currently we treat 53 high-risk patients with LDL apheresis, including 6 post- heart transplant patients and 5 patients with immunoadsorption. Since November 1990 we have seen a marked reduction in the number of new cardiovascular events by apheresis intervention, but they could not be totally prevented and 2 patients died despite LDL apheresis treatment. In our clinical experience all 4 LDL apheresis methods appear equally effective. However, it is an advantage to have the ability to switch methods in patients in whom one method was less effective or less well tolerated. We also successfully treated patients suffering from Evans' syndrome, pemphigus, urticaria vasculitis with monoclonal gammopathy IgM Type Kappa, lichen myxoedematosus or lupus erythematodes with immunoadsorption. The rheophoresis approach has been used in patients with age-dependent degeneration of the macula, sudden hearing loss, leg ulcers, and diabetic foot syndrome.