Pediatric Therapeutic Apheresis

  • Stuart L. Goldstein
  • Gunter Klaus
  • David F. Friedman
  • David F. Friedman
  • Haewon C. Kim


The term “apheresis” is derived from a Greek word meaning “removal.” In its most general sense, apheresis refers to techniques for large-scale removal of selected components of the blood. “Plasmapheresis” refers to removal of plasma, “erythrocytapheresis” to removal of red blood cells, and “leukapheresis” to removal of white blood cells. In the first part of this chapter we (SLG, DFF, HCK) will give an overview of apheresis techniques in general as currently practiced in the United States, describe some of the issues that are unique to the application of apheresis techniques in pediatrics, and will review indications for use of apheresis in patients with kidney disease. The latter portion of the chapter (GK) is devoted to an in-depth description of low-density lipoprotein (LDL) apheresis, a specialized application of apheresis technology, as it is currently practiced in Europe.


apheresis pediatric therapeutic apheresis 


  1. 1.
    Nguyen TC, Han YY, Kiss JE, et al. Intensive plasma exchange increases a disintegrin and metalloprotease with thrombospondin motifs-13 activity and reverses organ dysfunction in children with thrombocytopenia-associated multiple organ failure. Crit Care Med. 2008;36(10):2878–87.PubMedCrossRefGoogle Scholar
  2. 2.
    Chopek M, McCullough J. Protein and biochemical changes during plasma exchange. Washington: AABB Press; 1980.Google Scholar
  3. 3.
    Strauss R, McLeod B. Adverse reactions to therapeutic apheresis. Bethesda: AABB Press; 1996.Google Scholar
  4. 4.
    Dzik WH, Kirkley SA. Citrate toxicity during massive blood transfusion. Transfus Med Rev. 1988;2(2): 76–94.PubMedCrossRefGoogle Scholar
  5. 5.
    Olson PR, Cox C, McCullough J. Laboratory and clinical effects of the infusion of ACD solution during plateletpheresis. Vox Sang. 1977;33(2):79–87.PubMedCrossRefGoogle Scholar
  6. 6.
    Szymanski IO. Ionized calcium during plateletpheresis. Transfusion. 1978;18(6):701–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Bunchman TE, Maxvold NJ, Barnett J, Hutchings A, Benfield MR. Pediatric hemofiltration: Normocarb dialysate solution with citrate anticoagulation. Pediatr Nephrol. 2002;17(3):150–4.PubMedCrossRefGoogle Scholar
  8. 8.
    Mair DC, Hirschler N, Eastlund T. Blood donor and component management strategies to prevent transfusion-related acute lung injury (TRALI). Crit Care Med. 2006;34(Suppl 5):S137–43.PubMedCrossRefGoogle Scholar
  9. 9.
    Snyder Jr HW, Cochran SK, Balint Jr JP, et al. Experience with protein A-immunoadsorption in treatment-resistant adult immune thrombocytopenic purpura. Blood. 1992;79(9):2237–45.PubMedGoogle Scholar
  10. 10.
    George JN, Woolf SH, Raskob GE, et al. Idiopathic thrombocytopenic purpura: a practice guideline developed by explicit methods for the American Society of Hematology. Blood. 1996;88(1):3–40.PubMedGoogle Scholar
  11. 11.
    Furst D, Felson D, Thoren G, Gendreau R. Immunoadsorption for the treatment of rheumatoid arthritis: final results of a randomized trial. Prosorba Trial Investigators. Ther Apher. 2000;4(5):363–73.PubMedCrossRefGoogle Scholar
  12. 12.
    Hughes LB, Moreland LW. New therapeutic approaches to the management of rheumatoid arthritis. BioDrugs. 2001;15(6):379–93.PubMedCrossRefGoogle Scholar
  13. 13.
    Freiburghaus C, Berntorp E, Ekman M, Gunnarsson M, Kjellberg BM, Nilsson IM. Immunoadsorption for removal of inhibitors: update on treatments in Malmo-Lund between 1980 and 1995. Haemophilia. 1998; 4(1):16–20.PubMedCrossRefGoogle Scholar
  14. 14.
    Nilsson IM, Freiburghaus C. Apheresis. Adv Exp Med Biol. 1995;386:175–84.PubMedCrossRefGoogle Scholar
  15. 15.
    Uehlinger J, Button GR, McCarthy J, Forster A, Watt R, Aledort LM. Immunoadsorption for coagulation factor inhibitors. Transfusion. 1991;31(3):265–9.PubMedCrossRefGoogle Scholar
  16. 16.
    Bohmig GA, Regele H, Saemann MD, et al. Role of humoral immune reactions as target for antirejection therapy in recipients of a spousal-donor kidney graft. Am J Kidney Dis. 2000;35(4):667–73.PubMedCrossRefGoogle Scholar
  17. 17.
    Braun N, Kadar JG, Risler T. Therapeutic immunoadsorption – its role in clinical practice. Transfus Sci. 1998;19(Suppl):65–9.PubMedGoogle Scholar
  18. 18.
    Bueno Jr D, Sevigny J, Kaplan AA. Extracorporeal treatment of thrombotic microangiopathy: a ten year experience. Ther Apher. 1999;3(4):294–7.PubMedCrossRefGoogle Scholar
  19. 19.
    Bygren P, Freiburghaus C, Lindholm T, Simonsen O, Thysell H, Wieslander J. Goodpasture’s syndrome treated with staphylococcal protein A immunoadsorption. Lancet. 1985;2(8467):1295–6.PubMedCrossRefGoogle Scholar
  20. 20.
    Dantal J, Bigot E, Bogers W, et al. Effect of plasma protein adsorption on protein excretion in kidney-transplant recipients with recurrent nephrotic syndrome. N Engl J Med. 1994;330(1):7–14.PubMedCrossRefGoogle Scholar
  21. 21.
    Esnault V, Bignon JD, Testa A, Preud’homme JL, Vergracht A, Soulillou JP. Effect of protein A immunoadsorption on panel lymphocyte reactivity in hyperimmunized patients awaiting a kidney graft. Transplantation. 1990;50(3):449–53.PubMedCrossRefGoogle Scholar
  22. 22.
    Esnault VL, Besnier D, Testa A, et al. Effect of protein A immunoadsorption in nephrotic syndrome of various etiologies. J Am Soc Nephrol. 1999;10(9): 2014–17.PubMedGoogle Scholar
  23. 23.
    Haas M, Bohmig GA, Leko-Mohr Z, et al. Peri-operative immunoadsorption in sensitized renal transplant recipients. Nephrol Dial Transplant. 2002;17(8): 1503–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Hickstein H, Korten G, Bast R, Barz D, Nizze H, Schmidt R. Immunoadsorption of sensitized kidney transplant candidates immediately prior to surgery. Clin Transplant. 2002;16(2):97–101.PubMedCrossRefGoogle Scholar
  25. 25.
    Hiesse C, Kriaa F, Rousseau P, et al. Immunoadsorption of anti-HLA antibodies for highly sensitized patients awaiting renal transplantation. Nephrol Dial Transplant. 1992;7(9):944–51.PubMedGoogle Scholar
  26. 26.
    Juckett M, Perry EH, Daniels BS, Weisdorf DJ. Hemolytic uremic syndrome following bone marrow transplantation. Bone Marrow Transplant. 1991;7(5): 405–9.PubMedGoogle Scholar
  27. 27.
    Mastrangelo F, Pretagostini R, Berloco P, et al. Immunoadsorption with protein A in humoral acute rejection of kidney transplants: multicenter experience. Transplant Proc. 1995;27(1):892–5.PubMedGoogle Scholar
  28. 28.
    Matic G, Bosch T, Ramlow W. Background and indications for protein A-based extracorporeal immunoadsorption. Ther Apher. 2001;5(5):394–403.PubMedCrossRefGoogle Scholar
  29. 29.
    Mittelman A, Bertram J, Henry DH, et al. Treatment of patients with HIV thrombocytopenia and hemolytic uremic syndrome with protein A (Prosorba column) immunoadsorption. Semin Hematol. 1989;26(2 Suppl 1): 15–18.PubMedGoogle Scholar
  30. 30.
    Pretagostini R, Berloco P, Poli L, et al. Immunoadsorption with protein A in humoral rejection of kidney transplants. ASAIO J. 1996;42(5): M645–8.PubMedCrossRefGoogle Scholar
  31. 31.
    Snyder Jr HW, Mittelman A, Oral A, et al. Treatment of cancer chemotherapy-associated thrombotic thrombocytopenic purpura/hemolytic uremic syndrome by protein A immunoadsorption of plasma. Cancer. 1993;71(5):1882–92.PubMedCrossRefGoogle Scholar
  32. 32.
    Watson PR, Guthrie Jr TH, Caruana RJ. Cisplatin-associated hemolytic-uremic syndrome. Successful treatment with a staphylococcal protein A column. Cancer. 1989;64(7):1400–3.PubMedCrossRefGoogle Scholar
  33. 33.
    Parhofer KG, Geiss HC, Schwandt P. Efficacy of different low-density lipoprotein apheresis methods. Ther Apher. 2000;4(5):382–5.PubMedCrossRefGoogle Scholar
  34. 34.
    Schmaldienst S, Banyai S, Stulnig TM, et al. Prospective randomised cross-over comparison of three LDL-apheresis systems in statin pretreated patients with familial hypercholesterolaemia. Atherosclerosis. 2000;151(2):493–9.PubMedCrossRefGoogle Scholar
  35. 35.
    Vella A, Pineda AA, O’Brien T. Low-density lipoprotein apheresis for the treatment of refractory hyperlipidemia. Mayo Clin Proc. 2001;76(10):1039–46.PubMedCrossRefGoogle Scholar
  36. 36.
    Adams DM, Schultz WH, Ware RE, Kinney TR. Erythrocytapheresis can reduce Iron overload and prevent the need for chelation therapy in chronically transfused pediatric patients. J Pediatr Hematol Oncol. 1996;18(1):46–50.PubMedCrossRefGoogle Scholar
  37. 37.
    Kim HC, Dugan NP, Silber JH, et al. Erythrocyta­pheresis therapy to reduce iron overload in chronically transfused patients with sickle cell disease. Blood. 1994;83(4):1136–42.PubMedGoogle Scholar
  38. 38.
    Stemmler J, Wittmann GW, Hacker U, Heinemann V. Leukapheresis in chronic myelomonocytic leukemia with leukostasis syndrome: elevated serum lactate levels as an early sign of microcirculation failure. Leuk Lymphoma. 2002;43(7):1427–30.PubMedCrossRefGoogle Scholar
  39. 39.
    Rowe JM, Lichtman MA. Hyperleukocytosis and leukostasis: common features of childhood chronic myelogenous leukemia. Blood. 1984;63(5):1230–4.PubMedGoogle Scholar
  40. 40.
    Maurer HS, Steinherz PG, Gaynon PS, et al. The effect of initial management of hyperleukocytosis on early complications and outcome of children with acute lymphoblastic leukemia. J Clin Oncol. 1988; 6(9):1425–32.PubMedGoogle Scholar
  41. 41.
    Steeper TA, Smith JA, McCullough J. Therapeutic cytapheresis using the Fenwal CS-3000 blood cell separator. Vox Sang. 1985;48(4):193–200.PubMedCrossRefGoogle Scholar
  42. 42.
    Benito AI, Gonzalez-Vicent M, Garcia F, et al. Allogeneic peripheral blood stem cell transplantation (PBSCT) from HLA-identical sibling donors in ­children with hematological diseases: a single center pilot study. Bone Marrow Transplant. 2001;28(6): 537–43.PubMedCrossRefGoogle Scholar
  43. 43.
    Diaz MA, Garcia-Sanchez F, Lillo R, Vicent MG, Vicario JL, Madero L. Large-volume leukapheresis in pediatric patients: pre-apheresis peripheral blood CD34+ cell count predicts progenitor cell yield. Haematologica. 1999;84(1):32–5.PubMedGoogle Scholar
  44. 44.
    Goldman JM, Horowitz MM. The international bone marrow transplant registry. Int J Hematol. 2002; 76(Suppl 1):393–7.PubMedCrossRefGoogle Scholar
  45. 45.
    Gorlin JB, Humphreys D, Kent P, et al. Pediatric large volume peripheral blood progenitor cell collections from patients under 25 kg: a primer. J Clin Apher. 1996;11(4):195–203.PubMedCrossRefGoogle Scholar
  46. 46.
    Marson P, Petris MG, Messina C, et al. Peripheral blood stem cell collection in pediatric oncohematology. Experience with patients weighing less than 15 kg. Minerva Pediatr. 2000;52(3):129–35.PubMedGoogle Scholar
  47. 47.
    Sevilla J, Gonzalez-Vicent M, Madero L, Diaz MA. Peripheral blood progenitor cell collection in low-weight children. J Hematother Stem Cell Res. 2002;11(4):633–42.PubMedCrossRefGoogle Scholar
  48. 48.
    Torrabadella M, Olive T, Ortega JJ, Massuet L. Enhanced HPC recruitment in children using LVL and a new automated apheresis system. Transfusion. 2000;40(4):404–10.PubMedCrossRefGoogle Scholar
  49. 49.
    Collins Jr RH, Shpilberg O, Drobyski WR, et al. Donor leukocyte infusions in 140 patients with relapsed malignancy after allogeneic bone marrow transplantation. J Clin Oncol. 1997;15(2):433–44.PubMedGoogle Scholar
  50. 50.
    Drobyski WR, Hessner MJ, Klein JP, et al. T-cell depletion plus salvage immunotherapy with donor leukocyte infusions as a strategy to treat chronic-phase chronic myelogenous leukemia patients undergoing HLA-identical sibling marrow transplantation. Blood. 1999;94(2):434–41.PubMedGoogle Scholar
  51. 51.
    Drobyski WR, Keever CA, Roth MS, et al. Salvage immunotherapy using donor leukocyte infusions as treatment for relapsed chronic myelogenous leukemia after allogeneic bone marrow transplantation: efficacy and toxicity of a defined T-cell dose. Blood. 1993;82(8):2310–18.PubMedGoogle Scholar
  52. 52.
    Gasparetto C, Gasparetto M, Morse M, et al. Mobilization of dendritic cells from patients with breast cancer into peripheral blood stem cell leukapheresis samples using Flt-3-Ligand and G-CSF or GM-CSF. Cytokine. 2002;18(1):8–19.PubMedCrossRefGoogle Scholar
  53. 53.
    Mandanas RA, Saez RA, Selby GB, Confer DL. G-CSF-mobilized donor leukocyte infusions as immunotherapy in acute leukemia relapsing after allogeneic marrow transplantation. J Hematother. 1998;7(5):449–56.PubMedCrossRefGoogle Scholar
  54. 54.
    Zic JA, Miller JL, Stricklin GP, King Jr LE. The North American experience with photopheresis. Ther Apher. 1999;3(1):50–62.PubMedCrossRefGoogle Scholar
  55. 55.
    Rook AH, Suchin KR, Kao DM, et al. Photopheresis: clinical applications and mechanism of action. J Investig Dermatol Symp Proc. 1999;4(1):85–90.PubMedCrossRefGoogle Scholar
  56. 56.
    Knobler R, Jantschitsch C. Extracorporeal photochemoimmunotherapy in cutaneous T-cell lymphoma. Transfus Apher Sci. 2003;28(1):81–9.PubMedCrossRefGoogle Scholar
  57. 57.
    Knobler R, Girardi M. Extracorporeal photochemoimmunotherapy in cutaneous T cell lymphomas. Ann N Y Acad Sci. 2001;941:123–38.PubMedCrossRefGoogle Scholar
  58. 58.
    Knobler R. Extracorporeal photochemotherapy – Present and future. Vox Sang. 2000;78(Suppl 2): 197–201.PubMedGoogle Scholar
  59. 59.
    Greinix HT, Volc-Platzer B, Rabitsch W, et al. Successful use of extracorporeal photochemotherapy in the treatment of severe acute and chronic graft-versus-host disease. Blood. 1998;92(9):3098–104.PubMedGoogle Scholar
  60. 60.
    Shinoda T. Photopheresis and leukocytapheresis: cytapheresis treatment against immune-mediated diseases. Ther Apher. 2002;6(4):245–6.PubMedCrossRefGoogle Scholar
  61. 61.
    Schneider M. Plasma- and lymphapheresis in autoimmune diseases. Z Rheumatol. 1996;55(2):90–104.PubMedGoogle Scholar
  62. 62.
    Costanzo-Nordin MR, Hubbell EA, O’Sullivan EJ, et al. Photopheresis versus corticosteroids in the therapy of heart transplant rejection. Preliminary clinical report. Circulation. 1992;86(Suppl 5):II242–50.PubMedGoogle Scholar
  63. 63.
    Meiser BM, Kur F, Reichenspurner H, et al. Reduction of the incidence of rejection by adjunct immunosuppression with photochemotherapy after heart transplantation. Transplantation. 1994;57(4):563–8.PubMedGoogle Scholar
  64. 64.
    Rossetti F, Dall’Amico R, Crovetti G, et al. Extracorporeal photochemotherapy for the treatment of graft-versus-host disease. Bone Marrow Transplant. 1996;18(Suppl 2):175–81.PubMedGoogle Scholar
  65. 65.
    Dall’Amico R, Rossetti F, Zulian F, et al. Photopheresis in paediatric patients with drug-resistant chronic graft-versus-host disease. Br J Haematol. 1997;97(4): 848–54.PubMedCrossRefGoogle Scholar
  66. 66.
    Adami R. Therapeutic thrombocytapheresis: a review of 132 patients. Int J Artif Organs. 1993;16(Suppl 5):183–4.PubMedGoogle Scholar
  67. 67.
    Baron BW, Mick R, Baron JM. Combined plateletpheresis and cytotoxic chemotherapy for symptomatic thrombocytosis in myeloproliferative disorders. Cancer. 1993;72(4):1209–18.PubMedCrossRefGoogle Scholar
  68. 68.
    Liumbruno G, Centoni PE, Ceretelli S, Sodini ML. Rapid reduction of platelet numbers in thrombocytosis. Ther Apher. 2000;4(5):374–6.PubMedCrossRefGoogle Scholar
  69. 69.
    Renner D, Queisser U, Martinez C, Queisser W. Treatment of excessive thrombocythemia in chronic myeloid leukemia by thrombocytopheresis and intravenous Thio-TEPA. Onkologie. 1987;10(5):324–6.PubMedCrossRefGoogle Scholar
  70. 70.
    Ullrich H, Kadar J, Waxenberger Y, et al. Therapeutic thrombocytapheresis in patients with myeloproliferative diseases with the cell separators Fresenius AS 104 and Cobe Spectra: biocompatibility and safety. Beitr Infusionsther. 1992;30:311–14.PubMedGoogle Scholar
  71. 71.
    Gerhardt RE, Ntoso KA, Koethe JD, Lodge S, Wolf CJ. Acute plasma separation with hemodialysis equipment. J Am Soc Nephrol. 1992;2(9):1455–8.PubMedGoogle Scholar
  72. 72.
    Price CA. Therapeutic plasma exchange in a dialysis unit. ANNA J. 1987;14(2):103–8.PubMedCrossRefGoogle Scholar
  73. 73.
    Nadler S, Hidalgo J, Bloch T. Prediction of blood volume in normal human adults. Surgery. 1962;51:224.PubMedGoogle Scholar
  74. 74.
    Kim HC. Therapeutic pediatric apheresis. J Clin Apher. 2000;15(1–2):129–57.PubMedCrossRefGoogle Scholar
  75. 75.
    Szczepiorkowski ZM, Winters JL, Bandarenko N, et al. Guidelines on the use of therapeutic apheresis in clinical practice – Evidence-based approach from the Apheresis Applications Committee of the American Society for Apheresis. J Clin Apher. 2010;25(3): 83–177.PubMedCrossRefGoogle Scholar
  76. 76.
    Owen HG, Brecher ME. Atypical reactions associated with use of angiotensin-converting enzyme inhibitors and apheresis. Transfusion. 1994;34(10):891–4.PubMedCrossRefGoogle Scholar
  77. 77.
    Thompson GR. LDL apheresis. Atherosclerosis. 2003;167(1):1–13. Review.PubMedCrossRefGoogle Scholar
  78. 78.
    Marks D, Thorogood M, Neil HA, Humphries SE. A review on the diagnosis, natural history, and treatment of familial hypercholesterolaemia. Atherosclerosis. 2003;168(1):1–14. Review.PubMedCrossRefGoogle Scholar
  79. 79.
    Brown MS, Goldstein JL. A receptor-mediated pathway for cholesterol homeostasis. Science. 1986; 232(4746):34–47. Review.PubMedCrossRefGoogle Scholar
  80. 80.
    Leigh SE, Foster AH, Whittall RA, Hubbart CS, Humphries SE. Update and analysis of the University College London low density lipoprotein receptor familial hypercholesterolemia database. Ann Hum Genet. 2008;72(Pt 4):485–98.PubMedCrossRefGoogle Scholar
  81. 81.
    Masaki N, Tatami R, Kumamoto T, Izawa A, Shimada Y, Takamatsu T, Katsushika S, Ishise S, Maruyama Y, Yoshimoto N. Ten-year follow-up of familial hypercholesterolemia patients after intensive cholesterol-lowering therapy. Int Heart J. 2005;46(5): 833–43.PubMedCrossRefGoogle Scholar
  82. 82.
    Coker M, Ucar SK, Simsek DG, Darcan S, Bak M, Can S. Low density lipoprotein apheresis in pediatric patients with homozygous familial hypercholesterolemia. Ther Apher Dial. 2009;13(2):121–8.PubMedCrossRefGoogle Scholar
  83. 83.
    Mabuchi H, Koizumi J, Shimizu M, Kajinami K, Miyamoto S, Ueda K, Takegoshi T. Long-term efficacy of low-density lipoprotein apheresis on coronary heart disease in familial hypercholesterolemia. Hokuriku-FH-LDL-Apheresis Study Group. Am J Cardiol. 1998;82(12):1489–95.PubMedCrossRefGoogle Scholar
  84. 84.
    Stefanutti C, Vivenzio A, Di Giacomo S, Mazzarella B, Bosco G, Berni A. Aorta and coronary angiographic follow-up of children with severe hypercholesterolemia treated with low-density lipoprotein apheresis. Transfusion. 2009;49(7):1461–70. Epub 2009 Mar 23.PubMedCrossRefGoogle Scholar
  85. 85.
    Kavey RE, Allada V, Daniels SR, Hayman LL, McCrindle BW, Newburger JW, Parekh RS, Steinberger J; American Heart Association Expert Panel on Population and Prevention Science; American Heart Association Council on Cardiovascular Disease in the Young; American Heart Association Council on Epidemiology and Prevention; American Heart Association Council on Nutrition, Physical Activity and Metabolism; American Heart Association Council on High Blood Pressure Research; American Heart Association Council on Cardiovascular Nursing; American Heart Association Council on the Kidney in Heart Disease; Interdisciplinary Working Group on Quality of Care and Outcomes Research. Cardiovascular risk reduction in high-risk pediatric patients: a scientific statement from the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics. Circulation. 2006;114(24):2710–38. Epub 2006 Nov 27. Review.Google Scholar
  86. 86.
    Palcoux JB, Atassi-Dumont M, Lefevre P, Hequet O, Schlienger JL, Brignon P, Roussel B. Low-density lipoprotein apheresis in children with familial hypercholesterolemia: follow-up to 21 years. Ther Apher Dial. 2008;12(3):195–201.PubMedCrossRefGoogle Scholar
  87. 87.
    Böhler J, Schollmeyer P, Dressel B, Dobos G, Hörl WH. Reduction of granulocyte activation during hemodialysis with regional citrate anticoagulation: dissociation of complement activation and neutropenia from neutrophil degranulation. J Am Soc Nephrol. 1996;7(2):234–41.PubMedGoogle Scholar
  88. 88.
    Gabutti L, Ferrari N, Mombelli G, Keller F, Marone C. The favorable effect of regional citrate anticoagulation on interleukin-1beta release is dissociated from both coagulation and complement activation. J Nephrol. 2004;17(6):819–25.PubMedGoogle Scholar
  89. 89.
    Stefanutti C, Di Giacomo S, Vivenzio A, Colloridi V, Bosco G, Berni A, Rabbone I, Cerutti F, Bertolini S. Low-density lipoprotein apheresis in a patient aged 3.5 years. Acta Paediatr. 2001;90(6):694–701.PubMedCrossRefGoogle Scholar
  90. 90.
    Hudgins LC, Kleinman B, Scheuer A, White S, Gordon BR. Long-term safety and efficacy of low-density lipoprotein apheresis in childhood for homozygous familial hypercholesterolemia. Am J Cardiol. 2008;102(9):1199–204.PubMedCrossRefGoogle Scholar
  91. 91.
    De Silvestro G, Tison T, Vicarioto M, Bagatella P, Stefanutti C, Marson P. The Italian Registry of Pediatric Therapeutic Apheresis: a report on activity during 2005. J Clin Apher. 2009;24(1):1–5.PubMedCrossRefGoogle Scholar
  92. 92.
    Soufi M, Kurt B, Schweer H, Sattler AM, Klaus G, Zschocke J, Schaefer JR. Genetics and kinetics of familial hypercholesterolemia, with the special focus on FH-Marburg).W556R. Atheroscler Suppl. 2009; 10(5):5–11.PubMedCrossRefGoogle Scholar
  93. 93.
    Geiss HC, Parhofer KG, Donner MG, Schwandt P. Low density lipoprotein apheresis by membrane differential filtration (cascade filtration). Ther Apher. 2000;3(3):199–202.Google Scholar
  94. 94.
    Seidel D, Armstrong VW, Schuff-Werner P. The HELP-LDL-apheresis multicentre study, an angiographically assessed trial on the role of LDL-apheresis in the ­secondary prevention of coronary heart disease. I. Evaluation of safety and cholesterol-lowering effects during the first 12 months. HELP Study Group. Eur J Clin Invest. 1991;21(4):375–83.PubMedCrossRefGoogle Scholar
  95. 95.
    Bosch T, Gahr S, Belschner U, Schaefer C, Lennertz A, Rammo J, for the DALI Study Group. Direct adsorption of low-density lipoprotein by DALI-LDL-apheresis: results of a prospective long-term multicenter follow-up covering 12,291 sessions. Ther Apher Dial. 2006;10(3):210–18.PubMedCrossRefGoogle Scholar
  96. 96.
    Uauy R, Zwiener RJ, Phillips MJ, Petruska ML, Bilheimer DW. Treatment of children with homozygous familial hypercholesterolemia: safety and efficacy of low-density lipoprotein apheresis. J Pediatr. 1992;120(6):892–8.PubMedCrossRefGoogle Scholar
  97. 97.
    Zwiener RJ, Uauy R, Petruska ML, Huet BA. Low-density lipoprotein apheresis as long-term treatment for children with homozygous familial hypercholesterolemia. J Pediatr. 1995;126(5 Pt 1):728–35.PubMedGoogle Scholar
  98. 98.
    Eminoglu TF, Yenicesu I, Tumer L, Okur I, Dilsiz G, Hasanoglu A. Lipid apheresis applications in childhood: experience in the University Hospital of Gazi. Transfus Apher Sci. 2008;39(3):235–40.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Stuart L. Goldstein
    • 1
    • 2
  • Gunter Klaus
    • 3
  • David F. Friedman
    • 4
  • David F. Friedman
    • 5
  • Haewon C. Kim
    • 6
    • 7
  1. 1.Department of PediatricsUniversity of Cincinnati College of Medicine, Division of Nephrology and Hypertension & The Heart InstituteCincinnatiUSA
  2. 2.Center for Acute Care Nephrology, Pheresis ServiceCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  3. 3.Pediatric Kidney CenterKfH-Kuratorium fur Dialyse und NierentransplantationMarburgGermany
  4. 4.Transfusion Service and Apheresis ServicePhiladelphiaUSA
  5. 5.Phlebotomy ServiceChildren’s Hospital of PennsylvaniaPhiladelphiaUSA
  6. 6.Apheresis ServiceThe Children’s Hospital of PhiladelphiaPhiladelphiaUSA
  7. 7.Department of PediatricsUniversity of Pennsylvania School of MedicinePhiladelphiaUSA

Personalised recommendations