Artificial Kidney, Artificial Liver, and Artificial Cells PDF
Preview Artificial Kidney, Artificial Liver, and Artificial Cells
Artificial Kidney, Artificial Liver, and Artificial Cells Artificial Kidney, Artificial Liver, and Artificial Cells Edited by Thomas Ming Swi Chang, M.D., C.M., Ph. D., F. R.C. P. (C) Professor of Physiology, Professor of Medicine Associate, Medical Research Council of Canada Director, Artificial Organs Research Unit Faculty of Medicine, McGill University Montreal, Quebec, Canada Plenum Press · New York and London Library of Congress Cataloging in Publication Data Main entry under title: Artificial kidney, artificial liver, and artificial cells. Includes index. 1. Hemodialysis-Congresses. 2. Artificial kidney-Congresses. 3. Artificial liver Congresses. I. Chang, Thomas Ming Swi. II. McGill University. Artificial Organs Re search Unit. [DNLM: 1. Perfusion-Congresses. 2. Kidney, Artificial-Congresses. 3. Artificial organs-Congresses. 4. Liver-Congresses. 5. Membranes, Artificial-Con gresses. 6. Cells-Congresses. 7. Hemodialysis-Congresses. 8. Charcoal-Congresses. W0665 A791 19771 RC901.7.A7A74 617'.95 77·18738 ISBN-13: 978-1-4684-2480-5 e-ISBN-13: 978-1-4684-2478-2 001: 10.1007/978-1-4684-2478-2 Proceedings of the McGill Artificial Organs Research Unit International Symposium, McGill University, April 20, 1977 © 1978 Plenum Press, New York Softcover reprint of the hardcover 1s t edition 1978 A Division of Plenum Publishing Corporation 227 West 17th Street, New York, N.Y. 10011 All rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher Preface There is a rapid increase in interest related to novel approaches in artificial kidneys, artificial liver, and detoxifi cation. Recent research has included the successful clinical appli cations of the principle of artificial cells for adsorbent hemo perfusion. Since it is 20 years ago at McGill that the first report on "Artificial Cells" was presented, I thought it might be useful to get together a small group of speakers and participants for a day before the ASAIO meeting to discuss some recent advances in the area of the clinical applications of artificial kidney, artificial liver and artificial cells with emphasis on adsorbent hemoperfusion. However, the enthusiastic supports of distinguished speakers, session chairmen and participants were such that the original pro jection of 100 participants had expanded to a preregistration total of 250, from Australia, Canada, England, France, Germany, Israel, Italy, Japan, The Netherlands, Scotland, Sweden and U.S.A. The program also expanded to include a review section on hemodialysis, dialysate regeneration, hemofiltration, resin hemoperfusion and oxystarch given by their respective originators. The remaining of the symposium emphasizes the status of the art on different encap sulated adsorbent hemoperfusion approaches. I would like to apolo gize to those who we could not accommodate of space limita beca~se tions. It is hoped that this symposium volume may be useful for them and for others who are interested in this area. Special thanks are due to Ms Joanne Toms for her excellent secretarial assistance for the conference and Mrs. Carol Fautrel for her help in the preparation of this volume; Dr. A. Chawla for organizing the audiovisual aspects; Professor F.C. MacIntosh for his suggestions in organizing the post conference special events; and the McGill Conferences and Special Events especially for organ izing the reception and banquets. The members of the Artificial Organs Research Unit who have volunteered their help for this sym posium included: M. Berman, Dr. A. Chawla, Dr. E. Chirito, G. Colantoni, Dr. J. Cousineau, Dr. J. Grunwald, C. Hayward, N. Kunter ian, C. Lister, P. Nasielski, P. O'Keefe, Dr. B. Reiter, E. Resur reccion and J. Toms. Many thanks are due to my wife, Lancy, for preparing the index for this volume. v PREFACE The research in this Unit has been enriched by past and present collaborators and members, especially: Dr. P. Barre, Mr. D. Cameron, Dr. J. Campbell, Dr. A. Chawla, Dr. E. Chirito, Dr. S. Chung, Dr. J. Coffey, Dr. C. Cole, Dr. J. Cousineau, Prof. J. Dirks, Mrs. P. Douglas, Dr. H. Duff, Mrs. C. Fautrel, Dr. A. Gonda, Dr. J. Grunwald, Dr. M. Habib, Mrs. C. Hayward, Mrs. M. Hewish, Mr. K. Holeczek, Mrs. L. Johnson, Mrs. N. Kunterian, Mrs. T. Lee-Burns, Mr. B. Lessor, Dr. M. Levy, Mr. C. Lister, Dr. K.S. Lo, Prof. F.C. MacIntosh, Mrs. N. Malave, Miss Celeste Malouf, Prof. S.G. Mason, Dr. M. McGoldrick, Miss M. Migchelsen, Mr. P. Nasielski, Dr. M. Poznansky, Dr. S. Prichard, Miss P. O'Keefe, Dr. B. Reiter, Mrs. E. Resurreccion, Dr. A. Rosenthal, Dr. J. Seely, Dr. E. Siu-Chong, Dr. A. Sniderman, Miss A. Stark, Miss J. Toms, Dr. P. Tung, Mrs. A. Versaza, Dr. B. Watson, and Miss W. Yensen. The support and encouragements in the past or at present in other ways by many others are also gratefully acknowledged, especially, Professor D. Bates, Professor J. Beck, Sir Arnold V.S. Bergen, Professor A. Burton, Professor R.F.P. Cronin, Professor O. Denstedt, Professor S. Freeman, Professor W. Kolff, Professor F.C. MacIntosh, Professor S.G. Mason, Professor G. Malcolm Brown, Professor M. McGregor, Professor R.J. Rossiter, Dr. P. Selkej and many others. The collaboration of Plenum Publishing Corp. in agreeing to publish this symposium volume is appreciated. The grant supports for this symposium from the following are gratefully acknowledged: Department of Physiology; McGill Univer sity Faculty of Medicine; McGill University Administration; Amicon Corp., U.S.A.; Becton & Dickenson Co., U.S.A.; Extracorporeal Med ical Specialties Inc., U.S.A.; Gambro Dialysatoren GmH, Germany; and Warner Lambert Foundation, U.S.A. The research of the Artificial Organs Research Unit is being supported by the Medical Research Council of Canada. Thomas Ming Swi Chang Address of Welcome 1 L. Yaffe INTRODUCTION 3 T. M. S. Chang REVIEWS OF HEMODIALYSIS, DIALYSATE REGENERATION, HEMOFILTRATION AND OXYSTARCH The Present Status and Perspectives of Hemodialysis 11 W. J. Kolff Current Status of Dialysate Regeneration for the Treatment of Chronic Uremia 23 Arthur Gordon, Andrew J. Lewin, Morton H. Maxwell and Martin Roberts Devising a Practical Suitcase Hemodialyzer • • 33 Eli A Friedman, James T. Hutchisson, Robert S. Galonsky and Richard L. Hessert Present Status of Hemofiltration • 39 Lee W. Henderson Oxystarch and Other Polyaldehydes: The Present Status in the Treatment of Uremia ••••••••• 47 Carmelo Giordano and Renato Esposito MICROENCAPSULATED ADSORBENT HEMOPERFUSION Artificial Cells for Artificial Kidney, Artificial Liver and Detoxification 57 Thomas Ming Swi Chang ~i viii CONTENTS Clinical Experience of Bead-Shaped Charcoal Haemoperfusion in Chronic Renal Failure and Fulminant Hepatic Failure •• • • • 79 Michio Odaka, Yoichiro Tabata, Hirotada Kobayashi, Yoichi Nomura, Hiromitsu Soma, Hiroyuki Hirasawa and Hiroshi Sato Hepatic Assist System Using Bead-Type Charcoal • 89 I. Amano, H. Kano, H. Takahira, Y. Yamamoto, K. Itoh, S. Iwatsuki, K. Maeda and K. Ohta Extracorporeal Immunoadsorbents for Specific Extraction of Circulating Immune Reactants 99 David S. Terman. and George Buffaloe Evaluation of Charcoal Hemoperfusion in Uremia 107 James F. Winchester Charcoal Hemoperfusion: Georgetown University Hospital Experience • • • • • • • • 117 Michael C. Gelfand Treatment of Fulminant Hepatic Failure by Charcoal Haemoperfusion and Po1yacrilonitri1e Haemodia1ysis • • • • • • • • • • • • • • • • 125 D. B. A. Silk and Roger Williams Use of Activated Adsorbent Haemoperfusion in Acute Intoxication • • • • • • • • 135 Roy Goulding Clinical Experience with Cellulose-Coated Carbon Hemoperfusion • • • • • • • • • • 143 A. M. Martin, J. K. Gibbins, A. Oduro, R. Herbert Hemoperfusion and Removal of Endogenous Uremic Middle Molecules • • • • 153 R. Oules, H. Asaba, M. Neuhauser, V. Yahiel, S. Baehrendtz, B. Gunnarsson, J. Bergstrom and P. Furst Charcoal Hemoperfusion in Mushroom Poisoning: Amanita Pha110ides •• • • 165 E. Denti, R. Triolo, V. Grivet and A. Rame110 Biocompatibility Studies of Hemoperfusion Systems for Liver and Kidney Support • 173 S. Sideman, E. Hoffer, L. Mor, J. M. Brandes, I. Rousseau, O. Better, D. Ben-Arie and S. Lupovitch CONTENTS ix OTHER ADSORBENT HEMOPERFUSION APPROACHES The Use of Membranes and Sorbents for Blood Detoxification: Cuprophan Sorbent Membranes • • • • • • • • • • • • 185 P. S. Malchesky and Y. Nose Combination of Hemodialysis and Hemoperfusion in a Single Hollow-Fiber Unit for Treatment of Uremia • • • • • 193 L. A. Castro, G. Hampel, R. Gebhardt, A. Fateh and H. J. Gurland The B-D Hemodetoxifier: Particulate Release and Its Significance • • • 199 John B. Hill and C. Russel Horres Fixed-Bed Charcoal Hemoperfusion in the Treatment of Drug Overdose and Chronic Renal Failure • • • • 209 Benjamin H. Barbour Experience with Resin Hemoperfusion 217 Jerry L. Rosenbaum Strathclyde Approach Towards Artificial Kidney, Artificial Liver and Detoxification 225 J. M. Courtney, J. D. S. Gaylor, R. Maini, G. B. Park and E. M. Smith COMMUNICATIONS Assessment of Two Rat Models of Fulminant Hepatic Failure for Testing Artificial Liver Devices • • • • • • • • • • 239 E. Chirito, B. Reiter, C. Lister and T. M. S. Chang Use of Albumin-Cellulose Nitrate Microencapsulated Charcoal Hemoperfusion: In Acute Digoxin Toxicity in Dogs • • • • • • • • • • • • 245 S. Prichard, E. Chirito, A. Sniderman and T. M. S. Chang Conversion of Urea and Ammonia to Amino Acid Using Sequential Enzymatic Reaction with Microencapsulated Multi-Enzyme Systems 249 J. Cousineau and T. M. S. Chang x CONTENTS Microencapsulated Charcoal Hemoperfusion for Galactosemia • 255 P. Nasielski and T. M. S. Chang The Filtration of Plasma from Whole Blood: A Novel Approach to Clinical Detoxification 259 Franco Castino, Leonard I. Friedman, Barry A. Solomon, Clark K. Colton and Michael J. Lysaght Ionsiv F-80 and Ionsiv W-85: Molecular Sieve Zeolite NH4+ Ion Exchangers for Removal of Urea Nitrogen • • • • • 267 John D. Sherman PANEL AND GENERAL DISCUSSIONS Chronic Renal Failure and Future Approaches 277 Benjamin T. Burton Status of Artificial Liver Support: 1977 • • • • • • • • • • • 281 Paul D. Berk Treatment of Acute Intoxication 293 George Schreiner Interrelation of Hemoperfusion, Plasma Clearance and Half Life 297 John F. Maher General Discussion 301 Thomas Ming Swi Chang Invited Speakers, Session Chairmen and Organizing Committee • 305 Index 309 ADDRESS OF WELCOME L. Yaffe Vice Principal, McGill University Montreal, Quebec, Canada I am very happy to welcome you here on behalf of Principal Bell and the Board of Governors. McGill is extremely proud of its Faculty of Medicine. McGill also prides itself on the fact that it has a tradition of excellence. In these days of egalitarianism, democratic society, etc., it is virtually considered elitist to be excellent, but I think your presence here today at a conference like this, shows that you yourselves are committed to this very same principle of excellence. Without this, scholarship in any discipline, especially in the sciences, could never survive. I want to congratulate Professor Chang on attracting such a distin guished group of people but I also want to congratulate the audience because when I took a look at the program and the length and content of the program, I recognized that it would take a certain kind of stamina to be able to endure this. I would be interested to see what you look like at about 5:30 or 6:00 this afternoon. I know you did not come here to hear me. You have a very long and a very good program. May I wish you a great deal of success in this con ference. Thank you very much.
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