Details

Autor(en) / Beteiligte

• Contini, Christine
• König, Brigitte
• Markfeld-Erol, Filiz
• Kunze, Mirjam
• Zschiedrich, Stefan
• Prömpeler, Heinrich
• Pütz, Gerhard
• Winkler, Karl

Titel

[285-POS]: H.E.L.P.-apheresis in hypertensive disorders of pregnancy

Ist Teil von

• Pregnancy hypertension, 2015-01, Vol.5 (1), p.142-142

Ort / Verlag

Elsevier B.V

Erscheinungsjahr

2015

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Alterations in lipoprotein metabolism have been proposed as a possible pathophysiologic factor for preeclampsia. Elevation of very low density lipoproteins (VLDL) and predominance of atherogenic small dense low density lipoproteins (sdLDL) have been demonstrated in preeclampsia. Heparin-mediated-extracorporeal-LDL-precipitation (H.E.L.P.)-apheresis is an established method for lipoprotein removal and regeneration of endothelial function in severe hyperlipidemia. Wang et al. (2006) successfully used H.E.L.P.-apheresis in a pilot study to prolong preeclamptic pregnancies. We investigated alterations in the lipidprofile and the effects of H.E.L.P.-apheresis in the prolongation of hypertensive pregnancies. Six patients with early pregnancy complicated by hypertension were treated with H.E.L.P.-apheresis. Blood was collected before and after apheresis and subjected to ultracentrifugation for determination of lipid parameters. A total of 23 apheresis treatments (2–6 per patient) were performed without severe complications. Within apoB-containing lipoproteins, VLDL (−58%) and sdLDL (L5: −65% and L6: −68%) were removed at highest proportion. Cholesterol was reduced by 32% and triglycerides by 44%. Soluble fms-like tyrosine kinase-1 (sFlt-1) and placenta-growth-factor (PlGF) were not removed by H.E.L.P. Pregnancies continued for 4–14 days and lung maturation was successfully initiated before termination of pregnancy by caesarean section. H.E.L.P.-apheresis appears to preferentially address atherogenic lipoproteins, relevant to preeclampsia. ▪ C. Contini: None. B. König: None. F. Markfeld-Erol: None. M. Kunze: None. S. Zschiedrich: None. H. Prömpeler: None. G. Pütz: None. K. Winkler: Commercial Interest: BBraun Melsungen AG provided the H.E.L.P.-system; Research Support: BBraun Melsungen AG; Speaker: BBraun Melsungen AG.