Paper Title
Recent Advances on Ldl-Cholesterol Removal

Abstract
INTRODUCTION: Patient with familial and homozygous hypercholesterolemia are resistant to drug therapy .They require extracorporeal cholesterol removal such as LDL-Pheresis. Purpose of the study was to prevent or treat coronary artery disease and the efficacy and safety of eight different methods to remove LDL-cholesterol. MATERIALS AND METHODS: Plasma exchange has been around for several years. It is not specific for cholesterol removal and requires albumin solution. We have performed plasmapheresis for many years. With recent advances we also performed Membrane plasmapheresis using Plasma Fractionation, Thermo Filtration, Double Filtration . We have used Chemo affinity Dextran Sulfate, Liposorba LDL- Pheresis in our center and investigated the result of heparin precipitation called HELP System, Immuno - adsorption system such as Anti - Apo B or Anti - LPa, and LDL removal from whole blood called DALI System. RESULTS and DISCUSSION: There are eight different Extracorporeal methods to remove LDL in patient with drug resistant familial hypercholesterolemia. Plasmapheresis is safe, effective, but is not specific. Membrane Fractionation, Double Filtration ,and Thermo Filtration are safe , effective and semi specific for LDL Pheresis. Dextran Sulfate affinity column, Liposorber, is safe, effective and specific for LDL removal. Immuno -Adsorptions are safe, effective and very specific to remove LDL. This is the best form of LDL - Pheresis and can be made for specific patient. HELP and DALI Systems are both safe, effective and specific to remove LDL. DALI is very simple method using whole blood and does not require plasma separation. CONCLUSION: The Recent advances to treat patients with familial drug resistant hypercholesterolemia made treatment more effective and more specific. There are 3 different surgeries that can be used, Partial Ileal Bypass, Porto-Caval Shunting andLiver Transplant. There is also Gene Therapy to treat defective LDL Receptor. Keywords- Cholesterol, Familial, Homozygous, Heart Disease