H.E.L.P. apheresis therapy in the treatment of severe hypercholesterolemia: 10 years of clinical experience.

In collaboration with B. Braun Melsungen AG, Germany, we were able to develop the heparin-mediated extracorporeal low-density lipoprotein (LDL) fibrinogen precipitation (H.E.L.P.) system and to introduce it into clinical use. The H.E.L.P. apheresis system is the most potent technique to reduce at the same time LDL, lipoprotein (a) (Lp[a]), and fibrinogen plasma concentrations if the physiological clearing mechanisms are insufficient and if diet and drugs fail to achieve a target concentration of 100 mg/dl LDL-cholesterol or lower, required for secondary prevention of coronary heart disease. The H.E.L.P. LDL apheresis system also improves plasma viscosity and microcirculation efficiently. The clinical experience with the H.E.L.P. system has proved its clinical utility; regression of coronary heart disease occurs, a decrease in events of coronary heart disease takes place, and acute as well as chronic impairment of microcirculation shows a remarkable improvement with H.E.L.P. therapy. For the future, the availability of this safe and efficient apheresis technique may help many patients who previously could not be treated adequately.