Long-term plasma exchange via Cimino fistula in patients with hypercholesterolemia.

Two patients with familial hypercholesterolemia were treated by long-term plasma exchange via an arteriovenous Cimino shunt using unselective membrane separation. Cholesterol was lowered to 40 percent (+/-3) of peak levels by each procedure. Sieving coefficient was 0.76 (+/-0.12). With a mean exchange interval of 11 days (+/-2), the peak cholesterol levels decreased from 406 mg per dl (+/-28) to 322 mg per dl (+/-27), the LDL fraction from 338 mg per dl (+/-9) to 265 mg per dl (+/-25) whereas the HDL fraction remained unchanged at 28 mg per dl (+/-4). Electrocardiographic stress testing improved in the first patient after treatment for 12 months.