Two patients with marked, intractable hypertriglyceridemia under treatment for chronic renal failure by hemodialysis were treated by either an apolipoprotein B-dependent removal of lipoproteins using dextran-sulfate cellulose column plasmapheresis or a size-dependent removal of lipoproteins using hollow fibers' filtration plasmapheresis. In one patient, a column packed with hollow fibers was used as a plasma separator and a dextran-sulfate cellulose column as an adsorbent. In another patient, because the hollow fibers' column could not separate plasma from whole blood, a centrifuge-type blood cell separator was used for the plasma separation. The amounts of plasma cholesterol, triglycerides and phospholipids removed by plasmapheresis using the combination of a hollow fibers' column and a dextran-sulfate cellulose column were 30%, 33%, and 30%, respectively, and the amounts removed by the combination of the centrifuge-type blood cell separator and the hollow fibers' column were 31%, 29%, and 27%, respectively. The efficiency of lipid removal was almost at the same rate in both patients. We thus have concluded that plasmapheresis could be used for the treatment of marked hypertriglyceridemia, such as type IV and V hyperlipoproteinemia, and that we prefer the centrifuge-type blood cell separator to the hollow fibers' column for plasma separation. The second filter must be chosen for each patient, depending on the size of their lipoproteins.
