A patient with (or a risk for) hyperlipidemic pancreatitis may benefit from a single course of plasmapheresis.


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)


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