SCTIMST successfully performs the first LDL apheresis procedure for the treatment of familial hypercholesterolemia

The Department of Cardiology and Transfusion Medicine, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST) successfully performed its first LDL (bad cholesterol) apheresis procedure on a 34-year-old woman suffering from homozygous familial hypercholesterolemia (HoFH), a rare genetic disease that results in extremely high cholesterol levels from a young age.

The intervention was led by a team consisting of Harikrishnan S., Professor (Senior Grade), and Manish Yadav from the Cardiology Clinic and Amita R., another Professor from the Transfusion Medicine Clinic.

HoFH is characterized by severely elevated LDL cholesterol above 400 mg/dL from birth, leading to premature atherosclerotic cardiovascular disease that begins in childhood. The literature says that a myocardial infarction (heart attack) can occur in the second decade of life. The untreated median life expectancy for HoFH is only 33 years.

“In our practice, we see cases of HoFH with premature coronary artery disease or blockages in the heart’s blood vessels. This patient also underwent coronary artery bypass graft surgery (CABG) at the very young age of 24. Despite taking the maximum tolerable dose of multiple cholesterol-lowering drugs, her low-density lipoprotein (LDL) Dr. 500 mg of cholesterol remained dangerously high. Dr.

The procedure involves taking blood from the patient and passing it through an apheresis machine that separates the plasma from the blood cells. The plasma is then passed through a special adsorption column that captures LDL cholesterol.

Treated plasma is recombined with blood cells and safely returned to the patient. The whole process takes about two to three hours and the LDL value drops dramatically. In this case, it dropped from 500 mg/dL to 40 mg/dL.

Thus, plasma apheresis effectively removes more than 60% of LDL cholesterol, but the procedure must be repeated every two to four weeks – for life – as the liver produces cholesterol again and the LDL level returns.

“There are other options like siRNA injections twice a year, but these are very expensive and not as effective as the apheresis process. The latter is the only option available without which the patient’s prognosis is bleak. Each of the sessions costs ₹70,000 as a special non-cholesterol-absorbing column used in the apheresis machine is recommended and its re-use is, according to Harish Dr.

The patient belongs to BPL category and could opt for this procedure as it is covered under Karunya Arogya Suraksha Padhathi (KASP). However, since the procedure must be repeated every two to four weeks, the KASP coverage would hardly be sufficient to sustain her.

This breakthrough marks a major step forward in the treatment of hereditary cholesterol disorders in Kerala and South India. SCTIMST now joins a select group of centers in India offering this advanced therapy.

Published – 02 Jun 2026 22:25 IST