Plasmapheresis for hyperlipidemic pancreatitis
- 1 January 2003
- journal article
- clinical trial
- Published by Wiley in Journal of Clinical Apheresis
- Vol. 18 (4), 181-185
- https://doi.org/10.1002/jca.10063
Abstract
Patients with triglyceride levels over 1,000 mg/dl are at high risk of developing acute pancreatitis. This study aimed to determine the effectiveness of plasma exchange (PE) in reducing triglyceride levels during an acute attack of hyperlipidemic pancreatitis (HLP). A total of 17 hypertriglyceridemic patients with the complication of acute pancreatitis received one course of PE treatment for one or two consecutive sessions. The respective mean removal rates during a single PE for triglyceride, cholesterol, amylase, and lipase were 66.3, 62.1, 70.0, and 84.8%, respectively. An additional one exchange increased the removal rate to 83.3, 66.2, 85.5, and 87.0%, respectively. For the two-sessions of treatment, the removal rates were higher for triglyceride (P=0.0015) and amylase with a borderline statistical significance (P=0.0641). Better triglyceride clearance correlated well with lower levels of transmembrane pressure (TMP) at 90 minutes after PE (r2=0.5782, P=0.0010) and shorter plasmapheresis duration (r2=0.2241, P=0.0427). Thirteen of seventeen patients (76.5%) recovered completely, eight patients in a single-session, and five in two-sessions. Two patients developed intra-abdominal abscess, necessitating surgical drainage and two patients died due to both septic shock and multi-organ failure. No significant predictor of clinical outcome was identified. In summary, PE treatment is an effective method to clear lipids and enzymes from plasma in a single session for most HLP patients. A greater extraction of triglyceride would result in a reduced TMP and a shorter duration of PE treatment.Keywords
This publication has 14 references indexed in Scilit:
- Plasmapheresis for severe lipemia: Comparison of serum‐lipid clearance rates for the plasma‐exchange and double‐filtration variantsJournal of Clinical Apheresis, 2003
- Prevention of Recurrent Acute Pancreatitis in Patients with Severe HypertriglyceridemiaPancreas, 1996
- Hyperlipaemia intensifies the course of acute oedematous and acute necrotising pancreatitis in the rat.Gut, 1996
- Evaluation of Double Filtration Plasmapheresis, Thermofiltration, and Low–Density Lipoprotein Adsorptive Methods by Crossover Test in the Treatment of Familial Hypercholesterolemia PatientsArtificial Organs, 1996
- Acute PancreatitisNew England Journal of Medicine, 1994
- Extracorporeal lipid elimination for treatment of gestational hyperlipidemic pancreatitisGastroenterology, 1993
- The Risk of Transfusion-Transmitted InfectionNew England Journal of Medicine, 1992
- Cyclosporin‐induced hypertriglyceridemia with prompt response to plasma exchange therapyJournal of Clinical Apheresis, 1991
- Comparison of selectivity of LDL removal by double filtration and dextran-sulfate cellulose column plasmapheresis, and changes of subfractionated plasma lipoproteins after plasmapheresis in heterozygous familial hypercholesterolemiaMetabolism, 1987
- The Pathogenesis of Pulmonary Edema in Acute PancreatitisAnnals of Surgery, 1975