J.Jpn. Surg. Soc.. 79(5): 410-422, 1978

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Original article

STUDY ON HEMOPERFUSION FOR HEPATIC ASSIST
－ EVALUATION OF VARIOUS ACTIVATED CARBON AND COLUMN DESIGN －

An adsorption effect was experimentally studied for activated charcoal of different size. In the 5-10 mesh, 4% poly HEMA coated active carbon, removal rate for bilirubin was 16.9% and hexobarbiturate 50.1% in vitro. While bilirubin was 30.2% and hexobarbiturate was 89.9% in the 25-30 mesh, 10% poly HEMA coated active carbon. This study showed that small sized activated carbon was more effective than large sized one for charcoal hemoperfusion.
However, conventional type column (Model A) with small sized one was not useful because of blood clogging on the filter. For this reason the new type column for small sized carbon (Model B) was designed and evaluated in vivo study.
The perfusion had to be discontinued using 25-30 mesh, 10% poly HEMA, Model A because of filter clogging around 32 min., When 22% of fibrinogen and 49% of platelet were depleted. But the Model B was used, more the one hour of perfusion was possible with this system. Depletion rate of fibrinogen was 11% and platelet 22% at one hour.
The hemoperfusion effect of Model B with 25-30 mesh, 10% poly HEMA was evaluated in obstructive jaundice of dogs. The charcoal hemoperfusion was carried out at 3, 7, 10, 14, 17 and 21 days after the common bile duct ligation. Bilirubin level, in control group, reached 6.13 mg/dl±0.6 (SE) at 3 weeks. Perfusion group showed gradual increase, but the rate was less than that of control group. At 3 weeks, it was 4.97±0.2. GOT and GPT levels in perfusion group remained lower than those in control group. This would imply that the degree of hepatocellular damage due to obstructive jaundice were controlled or suppressed in perfused group.
It is believed that feasibility of the system to utilize the small sized charcoal is established and clinical evaluation is warranted.

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