Leukopenia, Hypoxemia, and Complement Activation During a Single Hemoperfusion

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Abstract
White blood cell count, acid-base balance, PO2 [O2 partial pressure], and complement function in 5 uremic patients undergoing a single hemoperfusion using activated charcoal coated with methacrylate were studied. After 20 min on hemoperfusion, a marked leukopenia [ranging from 6080 .+-. 526 to 3740 .+-. 1124 (P < 0.02)] and hypoxemia [ranging from 106 .+-. 13.8 to 80.2 .+-. 11.9 mm Hg (P < 0.02)] were observed. At the same time, total hemolytic complement decreased from 135 .+-. 15.7 to 123 .+-. 14.7 U/ml (P < 0.001) and alternative pathway activity from 38.1 .+-. 5.1 to 33.1 .+-. 6.7 U/ml (P < 0.005). C3 [complement component 3] and [factor] B cleavage fragments were detected in the samples tested, thus demonstrating the activation of the complement alternative pathway. After 60 min, the different parameters tended to increase but did not reach the baseline levels. A direct correlation between the degree of leukopenia and the reduction of PO2 throughout the hemoperfusion period was found. pH, PCO2 [CO2 partial pressure] and HCO3- did not change throughout the hemoperfusion period. Evidently, complement activation, leukopenia and hypoxemia occur during hemoperfusion.