USE OF CALCIUM CHELATING-AGENTS AND PROSTAGLANDIN-E1 TO ELIMINATE PLATELET AND WHITE BLOOD-CELL LOSSES RESULTING FROM HEMOPERFUSION THROUGH UNCOATED CHARCOAL, ALBUMIN-AGAROSE GEL, AND NEUTRAL AND CATION-EXCHANGE RESINS

  • 1 January 1977
    • journal article
    • research article
    • Vol. 89  (1) , 110-119
Abstract
Hemoperfusion through absorbents such as charcoal, cation exchange (e.g., AG 50W-X8) and uncharged (e.g., XAD-2) resins, and albumin-agarose gel (AAG) was proposed for use in patients with hepatic failure. However, the loss of white blood cells and, particularly, platelets caused by each of these adsorbents remains a major deterrent to their clinical use. In vitro studies demonstrated that addition of citrate, EDTA or oxalate to heparinized human blood eliminated this loss of formed blood elements during hemoperfusion. The improvement in postperfusion platelet counts (per cent of preperfusion values) produced by citrate were XAD-2, 13-95%; AG 50W-X8, 10-94%; AAG, 17-94%; and charcoal, 44-96%. Prostaglandin E1 in high doses (5 .mu.g/ml) markedly reduced platelet losses. Lower doses were less uniformly effective. Three young rhesus monkeys were hemoperfused for 160 min with columns containing AAG, XAD-2 and charcoal. During the 1st 80 min, citrate and Ca were infused into the column inflow and outflow lines, respectively. For all 3 adsorbents, average platelet counts in the monkeys (115%) and column effluent (95%) were unchanged from preperfusion control values during the first 80 min but fell promptly to 13 and 7%, respectively, after the citrate infusion was stopped. Each of the monkeys tolerated the procedure without ill effects.