Patient selection:
(1) chylomicronemia syndrome or markedly elevated triglycerides (> 1,000 mg/dL)
(2) pancreatitis, history of recurrent pancreatitis or perceived risk for pancreatitis
Number of sessions in a plasmapheresis course: 1 or 2
Consequences of plasmapheresis:
(1) more rapid clearance of plasma lipids (within a few hours)
(2) reduction in circulating levels of amylase and lipase
(3) delivery of lipoprotein lipase and apolipoprotein if FFP used for replacement
Causes of decreased benefit from the plasmapheresis:
(1) delay in initiating plasmapheresis (the sooner the better after symptom onset)
(2) inadequate plasmapheresis
(3) multi-organ failure (more severe pancreatitis)
(4) failure to coordinate with other control measures (primarily drug therapy)
