TREATMENT OF ALUMINUM OVERLOAD USING A CARTRIDGE WITH IMMOBILIZED DESFERRIOXAMINE

Intravenous desferrioxamine (DFO) is the method commonly used to treat aluminum toxicity. This laboratory has developed a hollow fiber devic e with immobilized DFO, an ''Aluminum DFO-HP'' (DFO-HP), for the purpo se of removing aluminum without the chelator (DFO) entering the blood. With Food and Drug Administration approval, a polysulfone DFO-HP, pla ced in the extracorporeal circuit in series with the patient's customa ry dialyzer, was tested for its safety and ability to remove aluminum in patients with ESRD who had aluminum overload. During treatment with this device, no toxic reactions, side effects, or hematologic or clin ical laboratory changes were seen other than those associated with dia lysis. Average aluminum clearance with the DFO-HP device was 25.3 mL/m in with a range of 7.2 to 52.4 mL/min, whereas aluminum clearance with the F-60 polysulfone high-flux dialyzer was 8.4 mL/min. Aluminum clea rance of the cuprophane dialyzers in series with the DFO-HP was neglig ible. The amount of aluminum removed over a 2-h treatment with DFO-HP ranged from 94 to 628 mu g, which corresponded to 32 to 199% of the in itial aluminum in the circulation before that particular treatment. Th e excess 99% was provided from aluminum released from tissue sites int o the circulation throughout the duration of the treatment. It is expe cted that, because of the efficiency and safety of the DFO-HP device, the time presently needed for aluminum depletion using intravenous DFO will be greatly shortened and the potential toxicity of intravenous D FO will be eliminated.