Artificial Kidney, Artificial Liver, and Artificial Cells

306 Pages·1978·8.46 MB·English

by  L. Yaffe (auth.)

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.