Abstract
Rearoval of toxic substances from the circulating blood of patients with severe hapatic failures may be life-saving. Hemoperfusion with activated charcoal has been reported to be sometimes effective in recovering patients from hepatic coma, although the exact mechanism and removed substances from the blood responsible for these improvements has yet to be clarified. In the previous study, we have revealed that IONEX (Toray Industries) adsorbs both direct and indirect bilirubin from the blood in vitro. This removal of bilirubin from the blood has also been confirmed in direct hemoperfusion of the jaundiced dogs. It has been found that the removal of bilirubin is disturbed by thrombus formation on the IONEX fibers.
Prostagrandins (PG E1 or PG I2) was administered continuously into the arterial line of the extracorporeal circulation using IONEX column during the two-hour direct hemoperfusion. Thrombus formation in the IONEX column was not observed and the average removal rate of bilirubin from the blood of the jaundiced dogs was as much as 40%. It has also been found that bile acid in the blood is removed by direct hemoperfusion with IONEX. Average removal rate of bile acid after two-hour perfusion with 70gm of IONEX was 60%.
