Manipal Hospital did the first plasma filtration for a woman and became the first hospital in the country to do such a feat.
Suma (name changed), 34 years old, suffering from Homozygous Familial Hypercholesterolemia (HOFH) since 2014, was referred to Manipal Hospital, Old Airport Road, Bengaluru.
Let us tell you that Hofh is a condition where two abnormal genes are inherited by a patient from each parent.
This leads to very high levels of bad cholesterol which gets deposited in the blood vessels leading to heart disease and premature death.
Heart bypass surgery was done in 2021.
The patient also developed cardiac symptoms and was referred to Dr. Devanand NS, Head & Consultant – Cardiothoracic Vascular Surgery & Lung Transplant Surgery, Manipal Hospital Old Airport Road, Bengaluru for heart bypass surgery in 2021.
Post-surgery she was referred to Dr. WG CDR SS Iyengar, Consultant – Cardiologist, Manipal Hospital near Old Airport Road for further management and treated with statins and lipid-lowering agents.
During her first pregnancy in 2018, she had a miscarriage at 7-8 weeks of pregnancy. She conceived for the second time in early 2022.
In view of the high-risk pregnancy, lack of efficacy, and inability to use certain drugs in pregnancy, the Lipoprotein apheresis procedure was considered by Dr. SS Iyengar and the patient was referred to the Department of Transfusion Medicine.
Lipoprotein apheresis is a procedure similar to dialysis, where the patient’s blood is passed through cascade filters that remove bad cholesterol and return the filtered blood (plasma) to the patient.
Since the production of cholesterol in the body is a continuous process, this process has to be repeated every 15 days to keep the cholesterol level under control.
Lipid Apheresis is a very rare procedure.
A total of 5 procedures costing around Rs 75,000/- in each session starting from 22 weeks were done free of cost due to the support of Manipal Hospital Management and Lipid Association of India who sponsored the medicines free of cost.
Keeping in view the cost constraint, the procedures were spaced at 1-month intervals till the delivery.
Fetal monitoring and obstetric care during the procedure were provided by Dr. Gayatri Karthik Nagesh, HOD and Consultant – Obstetrics and Gynaecology.
A healthy baby boy was delivered by cesarean section on 6th January 2023 and both mother and child are fine.
Neonatal care was provided by Dr. Karthik Nagesh, Chairman, and HOD, of Neonatal ICU, and Manipal Advanced Children’s Center.
Let us tell you that lipid apheresis is a very rare procedure and Manipal Hospital, Old Airport Road is the first hospital in the country to do it during pregnancy.
Filter cost in all Lipoprotein Apheresis procedures is as expensive as Rs.50,000/- and Plasmapheresis which costs around Rs.10,000/-.
Most of these patients cannot afford the filters and need help from the government and charitable organizations.