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Italian Multicenter Study on Low-Density Lipoprotein Apheresis: Retrospective Analysis (2007)

Authors

  • Claudia Stefanutti,

    1. Plasmapheresis Unit, Department of Clinical and Medical Therapy, University of Rome “La Sapienza”, Umberto I Hospital, Rome, Italy
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  • the Italian Multicenter Study on Low-density Lipoprotein Apheresis Working Group

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    • *

      Italian Multicenter Study on Low-Density Lipoprotein Apheresis (IMS-LDLa) Working Group (presented for each center involved in the study):
      L'Aquila: Luigi Dell'Orso, Unit of Immunohematology and Transfusion Medicine, “S Salvatore” Hospital, L'Aquila
      Bari 1: Alfonso Ramunni, Nephrology 1, Department of Internal Medicine and Public Medicine, University of Bari
      Bari 2: Tommaso De Palo, Unit of Pediatric Nephrology and Dialysis, “Giovanni XXIII” Hospital, Bari
      Cagliari: Paolo Pintus and Sandra Anedda, Center of Metabolic and Atherosclerotic Disease, “G Brotzu” Hospital
      Milan: Ghil Busnach, Unit of Nephrology, Dialysis and Renal Transplantation Therapy, “Niguarda Ca'Granda” Hospital
      Nuoro: Patrizia Vatieri, Unit of Nephrology and Dialysis, “San Francesco” Hospital
      Padova: Giustina De Silvestro and Piero Marson, Unit of Immunotransfusional Medicine, Padova Hospital, University of Padova
      Palermo: Rosalia Agliastro, Unit of Immunohematology and Transfusion Medicine, “G Di Cristina e M Ascoli” Hospital
      Pistoia: Giovanna D'Alessandri and Adriana Tognaccini, Unit of Immunohematology and Transfusion Medicine, Azienda USL 3, Pistoia
      Prato: Amato Marcello, Department of Nephrology, Azienda USL 4, Prato Hospital
      Reggio Emilia: Gianpaolo Russi, Unit of Transfusion Medicine and Immunohematology, “Santa Maria Nuova” Hospital
      Rome: Claudia Stefanutti (coordinator and corresponding author) and Serafina Di Giacomo, Department of Clinical and Medical Therapy, Plasmapheresis Unit, University of Rome “La Sapienza”, “Umberto I” Hospital
      Sassari 1: Giuseppe Piredda, Anesthesia and Intensive Care, University of Sassari
      Sassari 2: Maria Cossu and Pietro Giorgio Pala, Unit of Nephrology, Dialysis and Transplantation, Azienda USL 1, “SS Annunziata” Hospital
      Sassari 3 (Ozieri): Luciangela Calvisi, Unit of Nephrology and Dialysis, “Antonio Segni” Hospital
      Trieste: Luigi Cattin and Maurizio Fonda, Medicine III, Service of Diabetes and Metabolic Diseases, Cattinara Hospital Ospedali Riuniti Di Trieste
      Varese (Gallarate): Lorella Poli, Unit of Transfusion Medicine and Immunohematology, “S Antonio Abate” Hospital
      Verona: Maria Grazia Zenti, Endocrinology and Metabolic Diseases, “Civile Maggiore” Hospital
      Viterbo: Maria Rita Guitarrini, Department of Transfusion Medicine, North Lazio Azienda USL Viterbo, “Bel Colle” Hospital


Professor Claudia Stefanutti, Dipartimento di Clinica e Terapia Medica, Università di Roma “La Sapienza”, Policlinico Umberto I, Viale del Policlinico155, 00161 Roma, Italia. Email: plasmaferesi@tin.it

Abstract

A retrospective study—the Italian Multicenter Study on Low-density Lipoprotein Apheresis (IMS-LDLa)—was carried out, which involved 19 centers for LDLa in Italy, distributed all over the country—in the north, center, south, and the major islands. The survey was conducted through two consecutive questionnaires, which can be downloaded online from a dedicated site. The total number of procedures performed until 2007 was 31 012, and the number of patients undergoing treatment until 2007 were 229. The treated patients still surviving consisted of 136 (74 males and 62 females); those surviving but not treated numbered 95, and those deceased numbered 14. The techniques utilized, listed by frequency of use, were the following: dextran sulfate cellulose adsorption, direct adsorption of lipids (DALI), heparin extracorporeal LDL precipitation, immunoadsorption, plasma-exchange, cascade filtration, and Lipocollect 200. The mean treated plasma and blood volumes per session were 3916.5 mL and 8735.1 mL, respectively. The most frequently utilized vascular access points were: venous 84.4% and arteriovenous fistula 15.5%. Hematoma by venipuncture (230 episodes), low outlet flow (125 episodes), and circuit coagulation (44 episodes) were reported as to be the most frequent side effects. In the second questionnaire (filled in by 19 centers) the centers were asked to report their data on: quality diagnosis of dyslipidemia and referents for genetic-molecular and clinical diagnosis, cholesterol-lowering drugs and dosages, typology of cardiovascular check-ups at the beginning of treatment and in follow-up, non-cholesterol-lowering drugs with priority for cardiologic drugs, including oral anti-coagulants, and, lastly, information related to the appropriateness of curing patients still under treatment with LDLa and, where possible, news on patients no longer under treatment.

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