Therapeutic plasma exchange in hypertriglyceridemic patients

Turk J Med Sci. 2019 Jun 18;49(3):872-878. doi: 10.3906/sag-1811-105.

Abstract

Background/aim: High triglyceride (TG) levels are associated with increases in atherosclerotic cardiovascular disease (CVD), hepatic steatosis, and pancreatitis. Acute pancreatitis is a condition with high mortality. Therapeutic plasma exchange (TPE) in the treatment of hypertriglyceridemic pancreatitis (HTGP) is a rapid and effective treatment modality. In this study, the results of TPE were evaluated and the frequency of lipoprotein lipase (LPL) mutation in these patients was determined.

Materials and methods: TPE was performed in 31 patients with HTGP at the Adult Therapeutic Apheresis Center.

Results: A TG level under 500 mg/dL was achieved by applying apheresis at a median of 2 times (IQR 2–2, min 1, max 6) in the 31 cases. LPL mutation was detected in 8 (25.8%) of the 31 hypertriglyceridemia cases. When TG levels before and after TPE were evaluated, the mean TG level before TPE was significantly higher (3132 ± 1472 mg/dL) than the mean TG level afterwards (948 ± 465 mg/dL, P < 0.001). This result represented a decrease of 69.7% TG after TPE.

Conclusion: TPE is a safe, fast, and effective treatment modality in experienced centers.

Keywords: Hypertriglyceridemia; pancreatitis; apheresis; therapeutic plasma exchange; fresh frozen plasma.

MeSH terms

  • Adult
  • Female
  • Humans
  • Hypertriglyceridemia / blood
  • Hypertriglyceridemia / epidemiology
  • Hypertriglyceridemia / therapy*
  • Lipids / blood
  • Male
  • Middle Aged
  • Plasma Exchange*
  • Retrospective Studies

Substances

  • Lipids