Abstract
This study was undertaken to investigate the effect of a new extracorporeal system combining direct hemoperfusion (DHP) and veno-venous bypass on the elimination of anticancer drugs during intraarterial chemotherapy of the liver. Adriamycin (ADR, 3mg/kg) and Mitomycin C (MMC, 1mg/kg) were given to mongrel dogs through hepatic artery in three different duration of 1, 10 and 20 minutes. Blood flow through DHP averaged 200ml/min. In dogs without DHP (group I, n=4), plasma levels (μg/ml) of ADR and MMC in right external jugular vein (peripheral level) rapidly increased with one minute infusion, reaching the peak values of 6.61±2.44 (mean±SD) and 2.20±1.05 respectively. With DHP under single venous bypass for the blood access from IVC (group II, n=5), the peak values were lower reaching only 1.25±1.02 and 0.79±0.52. In addition, the peak levels were markedly reduced by DHP under hepatic venous isalation using veno-venous bypass (group III, n=8), the values being 0.41±0.15, and 0.13±0.07. These were 6.2 and 5.9% respectively versus each corresponding value of graup I (p<0.01). The longer the duration of infusion, the higher the removal rates tended to be in group III. In conclusion, extraregional distribution of anticancer drugs can be minimized by this extracorporeal system and therefore dose escalation may safely be performed during intraarterial chemotherapy of the liver.
