Multisorbent plasma perfusion in fulminant hepatic failure: Effects of duration and frequency of treatment in rats with Grade III hepatic coma

Using the model of galactosamine-induced fulminant hepatic failure in the r at, the effects of multisorbent plasma perfusion over Asahi uncoated spheri cal charcoal, Plasorba (BR-350) resin, and an endotoxin removing adsorbent (polymyxin B-sepharose) were determined in Grade III hepatic coma animals b y studying survival as influenced by timing, duration, and frequency of tre atment. The effects of treatment on liver cell proliferation and endotoxin removal also were examined. The results demonstrate that duration and frequ ency of treatment are major contributing factors in the successful applicat ion of nonbiological membrane-based multisorbent liver support systems. Exa mination of the regenerative activity in the liver indicates an enhanced pr oliferative response following multisorbent plasma perfusion compared with untreated fulminant hepatic failure (FHF) paired controls. Utilizing an end otoxin removal adsorbent alone, a marked reduction in systemic levels of en dotoxin in FHF was demonstrated compared with nonperfused FHF paired contro ls. Despite current emphasis on bioartificial liver support systems, plasma purification by multisorbent systems offers a simple method for the remova l of circulating toxic metabolites in general together with specific toxin removal.