A NEW LIVER SUPPORT SYSTEM: ON-LINE MEMBRANE PLASMAPHRESIS AND ADSORPTION OF BILIRUBIN AND BILE ACIDS: Experimental study

Abstract

A new tertiary amine type anion exchange resin (IONEX) which is capable of combining both bilirubin and bile acids has been developed for used in the artificial hepatic assist system. Direct hemoperfusion with IONEX fiber effectively reduced bilirubin and bile acids in the blood of the jaundiced dogs, however rather a large amount of heparin or Prostaglandin I₂ was necessary to prevent platelet adhesion to the IONEX fiber and to continue the extracorporeal circulation.
In order to avoid the hazards with the direct hemoperfusion, membrane plasmaphresis was performed using a new plasma separator (Toray PLASMAX), and on-line adsorption of bilirubin and bile acids in the membrane separated plasma, was performed experimentally in the jaundiced dog.
Mean reduction rate of bilirubin in the four dogs after 90-minute membrane plasmapheresis with on-line adsorption by IONEX fiber was 38.7% and that of bile acids was 56.5%.
The extracorporeal circulation with this system was performed without difficulty and no detectable derangement of plasma protein fractions.