LDL-Apheresis
DALI removes cholesterol from whole blood
The DALI system (DALI = Direct Adsorption of Lipoproteins) was developed by Fresenius researchers for people with a hereditary lipometabolism disorder. This is the first system that can remove LDL cholesterol (“bad cholesterol”) from whole blood without the separation of blood into blood cells and blood liquid (plasma). The DALI system is simple to operate and works safely and reliably.
People with a hereditary lipid metabolism disorder, known as familial hypercholesteremia, are often unable to reduce their high LDL cholesterol levels sufficiently with just diet and medications. These patients frequently suffer from arteriosclerosis at a young age and have a high risk of dying from coronary heart disease.
Adsorber Therapy Treatment
During treatment, blood flows from a vein in the arm of the patient through a tube into the DALI adsorber, the heart of the system.The DALI adsorber consists of a plastic housing that is filled with tiny, porous beads. Like a large sponge, these beads extract LDL cholesterol and also Lp(a) from the blood. The cleansed blood is returned to the patient via a tube in the vein of the other arm.
A machine continuously monitors the blood flow outside the body by pumping the blood, controlling its velocity and preventing air from entering the blood flow. After about one or two hours of treatment, the LDL cholesterol level of the blood can decrease more than 60 percent. The procedure is well tolerated by patients who require treatment once a week on average.
Lipoproteinfiltration with MONET
In contrast to the DALI system the blood is separated during the lipoproteinfiltration with MONET in a first step into the plasma and the blood cells with a plasmafilter. The plasma containing the LDL-cholesterol passes a secondary filter (MONET-Filter) which retains the Lipoproteins (LDL cholesterol and Lp(a)). The purified plasma is combined with the blood cells and returned to the patient. Besides the LDL cholesterol rheological active substances like Fibrinigen will be removed as well.
- Information brochure DALI (PDF-Datei, 512 KB)
Articles:
- L. J. Dräger, U. Julius, K. Kraenzle, J. Schaper, M. Toepfer, K. Zygan, V. Otto and E. Steinhagen-Thiessen: in European journal of Clinical lnvestigation (1998) 28, 994-1002
- E. Steinhagen-Thiessen: in European journal of Clinical lnvestigation (1998) 28, 994-1002
- T. Bosch, A. Lennertz, D. Schenzle, and J. Dräger for the DALl Study Group in Journal of Clinical Apheresis
- Thomas Bosch, Simon Gahr, Ulrike Belschner, Claudia Schaefer, Andrea Lennertz, and Jörg Rammo for the DALI Study Group in Therapeutic Apheresis and Dialysis 2006 10(3):210–218