Contents lists available at ScienceDirect Atherosclerosis journal homepage: www.elsevier.com/locate/atherosclerosis Practice of lipoprotein apheresis and short-term efficacy in children with homozygous familial hypercholesterolemia: Data from an international registry Ilse K. Luirink a,b,c,∗∗ , Barbara A. Hutten b , Susanne Greber-Platzer d , Genovefa D. Kolovou e , Eldad J. Dann f , Sarah D. de Ferranti g , Christina Taylan h , Eric Bruckert i , Samir Saheb i , Jun Oh j , Joenna Driemeyer j , Michel Farnier k , Lars Pape l , Claus P. Schmitt m , Francisco J. Novoa n , Martin Maeser o , Luis Masana p , Awad Shahrani q , Albert Wiegman a , Jaap W. Groothoff a a Department of Paediatrics, Amsterdam University Medical Centers, Amsterdam, the Netherlands b Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centers, Amsterdam, the Netherlands c Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, the Netherlands d Department of Pediatrics, University of Vienna, Vienna, Austria e Cardiology Department and Lipoprotein Apheresis Unit, Onassis Cardiac Surgery Center, Athens, Greece f Blood Bank and Apheresis, Rambam Health Care Campus, Haifa, Israel g Department of Cardiology, Boston Children's Hospital, Boston, USA h Children's and Adolescents' Hospital, University Hospital of Cologne, Cologne, Germany i Groupe Hospitalier Pitié-Salpêtrière, Service D'Endocrinologie, Métabolisme et Prévention des Maladies Cardiovasculaires, Paris, France j University Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany k Lipid Clinic, Point Médical, Rond-point de La Nation, Dijon, France l Pediatric Nephrology, Hannover Medical School, Hannover, Germany m Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany n Endocrinology Department, University Hospital Insular de Gran Canaria, University Institute of Biomedical and Health Research of the University of Las Palmas de Gran Canaria, Las Palmas, Spain o Landeskrankenhaus Feldkirch, Feldkirch, Austria p Unitat de Medicina Vascular i Metabolisme, Hospital Universitari Sant Joan, Universitat Rovira i Virgili, Spain q College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia HIGHLIGHTS • Lipoprotein apheresis (LA) is safe in children with hoFH with a paucity of side effects. • LA leads to an important reduction of LDL-C and xanthomas in children with hoFH. • Only a small number of children with hoFH reach treatment goals on LA. • There are important differences in LA conduction strategies between different sites. ARTICLEINFO Keywords: Children Familial hypercholesterolemia Homozygous Lipoprotein spheresis ABSTRACT Background and aims: Homozygous familial hypercholesterolemia (hoFH) may cause life-threatening athero- sclerotic cardiovascular disease in childhood. Lipoprotein apheresis (LA) is considered a pivotal treatment op- tion, but data on its efficacy, safety and optimal performance are limited. We therefore established an inter- national registry on the execution and outcomes of LA in HoFH children. Here we report LA policies and short- term outcomes. Methods: We approached centers worldwide, involved in LA in children with hoFH for participation. We col- lected information on clinical and treatment characteristics on patients aged 0–19 years between November 2016 and November 2018. Results: We included 50 children, treated at 15 sites. Median (IQR) LDL-C levels at diagnosis, on medication and on LA were 19.2 (16.2–22.1), 14.4 (10.8–16.7) mmol/L and 4.6 mmol/L, respectively. Median (IQR) time https://doi.org/10.1016/j.atherosclerosis.2020.01.031 Received 17 November 2019; Received in revised form 13 January 2020; Accepted 31 January 2020 ∗ Corresponding author. Amsterdam University Medical Centers, Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands. E-mail address: i.k.luirink@amsterdamumc.nl (I.K. Luirink). Atherosclerosis 299 (2020) 24–31 Available online 18 February 2020 0021-9150/ © 2020 Published by Elsevier B.V. T