B. Braun Medical Care AG Nephrology and Dialysis centers

H.E.L.P. apheresis

Heparin induced

H.E.L.P. (heparin-induced extracorporeal LDL precipitation) apheresis is a treatment method that has been in use for decades and was initially developed as a treatment option for refractory lipid metabolism disorders.
Over time, other medical indications were added that are a result of a microcirculatory disorder, such as idiopathic hearing loss and dry macular degeneration.

During the H.E.L.P. procedure, the plasma is first of all separated from the other components that make up the blood. Heparin and an acetate buffer are then added, which lower the plasma’s pH. This changes the surface charge of LDL-C, Lp(a) and other substances, which leads to increased binding to the heparin used. In addition to LDL, the process also filters out various inflammatory mediators (CRP, cytokines, etc.) as well as any virus components or spike proteins present. The resulting precipitates are filtered out and subsequently removed from the plasma in circulation through the machine. No antibodies or autoantibodies are removed in the process. The excess heparin is eliminated by adsorption. The physiologic pH is then restored by removing the buffer solution via dialysis. Finally, the purified blood is returned to the patient at the end of the treatment.

Based on recent literature, the presumed formation of microclots in blood samples from healthy subjects can be made visible under a microscope by adding spike protein.
It has already been shown in Long Covid patients that these microclots are dissolved by H.E.L.P. apheresis and that the spike protein is filtered out by binding to heparin. 

The number of rounds of apheresis required varies from patient to patient and also depends on the severity of the symptoms.

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