Problems in Treating Experimentally Induced Acute Hepatic Failure by Hemoperfusion or Cross Circulation

Authors

  • Robert A. F. M. Chamuleau,

    Corresponding author
    1. Laboratory of Experimental Internal Medicine, Wilhelmina Gasthuis, University of Amsterdam, Amsterdam, The Netherlands and Department of Chemical Technology, Biomaterials Section, Twente University, Enschede, The Netherlands
    • Robert A. F. M. Chamuleau, M.D., Laboratory of Experimental Internal Medicine, Wilhelmina Gasthuis, University of Amsterdam, Eerste Helmersstraat 104, Amsterdam 1054 EG, The Netherlands.
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  • Robert J. Popken,

    1. Laboratory of Experimental Internal Medicine, Wilhelmina Gasthuis, University of Amsterdam, Amsterdam, The Netherlands and Department of Chemical Technology, Biomaterials Section, Twente University, Enschede, The Netherlands
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  • Ellen C. Beyerbacht,

    1. Laboratory of Experimental Internal Medicine, Wilhelmina Gasthuis, University of Amsterdam, Amsterdam, The Netherlands and Department of Chemical Technology, Biomaterials Section, Twente University, Enschede, The Netherlands
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  • Henk W. M. De Koning

    1. Laboratory of Experimental Internal Medicine, Wilhelmina Gasthuis, University of Amsterdam, Amsterdam, The Netherlands and Department of Chemical Technology, Biomaterials Section, Twente University, Enschede, The Netherlands
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Abstract

Acute hepatic failure was induced in rats by galactosamine injection intraperitoneally (1 gm per kg). Twenty-four hours later rats were treated by hemoperfusion (HP) over encapsulated sorbents: cellulose acetate-coated charcoal, polyelectrolyte-coated XAD4, a combination of both, or cross circulation with a healthy donor. Compared with control treatment (prevention of hypoglycemia by glucose infusion), the survival rate was not improved by HP or cross circulation: controls 19% vs. treated animals 0 to 17%. Extension of duration or increased frequency of HP gave the same survival rates. Computer simulation based on zero-order introduction of a possible toxin into a two-compartment model shows that HP up to 5 hr per day is not able to clear the body effectively from the assumed toxin if its partition coefficient exceeds a value of 50.

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