J.Jpn. Surg. Soc.. 83(9): 1132-1135, 1982

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Report on the annual meeting

A NEW TREATMENT FOR THE PATIENTS WITH MULTIPLE ORGAN FAILURE FOLLOWING ALIMENTARY SURGERY

We have employed a new treatment for postoperative multiple organ failure (MOF) since September 1978. The new treatment is based on the hypothesis that depressed phagocytic activity of reticuloendothelial system (RES) plays an important role for the development of MOF, allowing the various toxins, bacteria spilling-over systemically without being phagocytized by the depressed RES and the experimental study that ATP-MgCl₂ is effective to normalize intracellular energy metabolism caused during low flow state. The outline of our new treatment is as follows :1) Application of direct hemoperfusion (DHP) using activated charcoal as an artificial RES, with the expectation that DHP detoxifies the toxins in blood stream while the patient's RES is depressed. 2) Enhancement of RES of a patient using minidose of heparin, ATP-MgCl₂, aprotinin and large dose of fresh frozen plasma. 3) Administration of ATP-MgCl2₂ to accelerate the recovery of the organs from ischemic insults.
Since September 1978, we have treated 11 patients with MOF following alimentary surgery with new regimen, of whom 6 survived. On the other hand, 24 patients with postoperative MOF, who were treated conventionally before September 1978, showed the survival rate of 38%. Thus the new treatment for MOF is effective to improve the survival.

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