Biocompatibility of Lipid Apheresis – New Aspects

Background: In principle extracorporeal systems like lipid apheresis (LA) represent an artificial, possible bioincompatible environment to blood components, due to by their non physiological surfaces. Investigations with hemodialysis tubings and membranes revealed contact activation of components of the immune system, formation of reactive oxygen radicals, and generation of lipid peroxidation products. In the case of LA this would be harmful and undesired since the atherosclerotic process induced by severe hyperlipidemia may be become aggravated by this extracorporeal therapy. Methods: Indicators for non physiological events during LA therapy were investigated in plasma, lipids and blood cells including gene expression studies. Results: Fortunately, no signs of any bioincompatibile reactions were noted during a single LA treatment in plasma and at the cellular level. In addition, no further acute effect of LA treatment on free radical scavenging enzymes (FRSE) could be detected both at the activity and gene level in white blood cells. Furthermore, no induction of stress genes occurred.Conclusion: For more than 25 years LA is well tolerated and safe for patients. In addition, based on our experience LA treatment seems to be very biocompatible.