IMPACT OF IMMUNOADSORPTION ON COMPLEMENT ACTIVATION, IMMUNOPATHOLOGY,AND HEPATIC PERFUSION DURING XENOGENEIC PIG-LIVER PERFUSION

Background. The impact of antibody adsorption by immunoapheresis on li ver damage, complement activation, and hepatic perfusion was evaluated against the background of an application in extracorporeal pig liver perfusion for hepatic coma, Methods, Eighteen pig livers were ex vivo perfused close to physiological conditions with fresh human blood for 4 hr, The influence of the perfusion circuit was investigated by perfu sions of the circuit in the absence of livers (group 1 [G1]; n=5), Liv ers were xenoperfused without modifications in group 2 (G2; n=6), In g roup 3 (G3; n=6), pure Sepharose columns were used prior to liver perf usion, Immunoapheresis with Ig-Therasorb 100 columns was used in group 4 (G4; n=6), Results, IgG was reduced by 95%, IgM by 72%, and IgA by 82% in G4, but only by about 30% in G3 (P<0.05), C4d, Bb fragment, and C3a levels were significantly lower in G4 than in G3 and G2 (P<0.05) after 180 min, Immunoadsorption diminished antibody and complement dep osition as well as hepatocellular damage in G4. Portal angiographies d emonstrated improved hepatic perfusion in G4. Conclusion, Immunoaphere sis reduced organ damage as well as complement activation and improved hepatic perfusion during xenogeneic pig liver perfusion.