Detoxification extracorporeal

A high fatality rate associated with this disease suggests that the effectiveness of conservative and surgical treatment is not sufficient in the case of acute pancreatitis. New methods of extracorporeal detoxification using hemoperfusion over carbon sorbents has made it possible to improve the outcome of pancreatitis treatment. However, hemosorption leads to only a transient decrease in blood proteolytic activity and does not correct the imbalance in the protease-inhibitor system, and the carbon hemosorbents are nonspecific. The development and application of antiprotease hemosorbents with specific bioligands therefore has potential in pancreatitis treatment. 

We snggest that the extracorporeal elimination of proteases from blood and decrease in the level of toxic and biologically active peptides stimnlate endogenous detoxification systems and improve functioning of the compensatory systems in the organism. 

Immunoadsorption, an advanced therapeutic modality, focuses on detoxification of patient blood rich in high-molecular-weight pathogenic substances, mostly abnormal autoantibodies such as rheumatoid factors in rheumatoid arthritis (RA) and anti-DNA autoantibodies in systemic lupus erythematosus (SLE). Detoxification of these pathogens will be accomplished through extracorporeal perfusion of the patient plasma or whole blood over an affinity column made of immunoadsorbents. These adsorbents perform their function through the same mechanism as conventional affinity adsorption, where proteins in the liquid phase are adsorbed on the specific ligands immobilized onto an insoluble support. 

Up to now, none of the presented system can claim its ability to fully replace all liver functions in an extracorporeal circuit. On the one hand, purely artificial techniques can only cover some detoxification aspects, which is already crucial in many clinical cases to save patients. On the other hand, bioartificial livers have not proven their full efficiency yet, mainly because both regulatory and logistic aspects limit, for the moment, the inclusion of significant numbers of patients to draw statistically relevant conclusions. 

The system sodium cellulose sulfate/PDADMAC permits the encapsulation of sensitive biological materials by a simple one step procedure. The broad variety of encapsulation problems so far successfully solved by this system includes the encapsulation of biocatalysts, hepatic microsomes for extracorporal detoxification, cattle embryos, " and various drugs for targeted or controlled-release delivery.f ... 

Liver Acute liver failure Porcine hepatocytes Polysulfone hollow fiber Extracorporeal support device Detoxification activity, bridge-to-transplantation [20]... 

Synthetic membranes are being used increasingly in medicine to process blood for a variety of therapeutic purposes. Such procedures are characterized by extracorporeal circulation and mass transfer across a synthetic membrane in direct contact with blood. The most common of these procedures is hemodialysis, which is used for the treatment of acute or chronic renal failure and drug detoxification (J ). Estimates Indicate... 

Extracorporeal Hollow Fiber Drug Detoxifier. After a functionally stable yS detoxification system had been developed, in vitro model EDD experiments were performed as schematically out-... 

The attachment of iron chelating ligands to polymers is an alternative means of modifying bioavailability. DFB has been covalently bonded to poly(acrolein) and other synthetic polymers and shown to have some potential for use in extracorporeal detoxification of acute iron overloaded plasma (57). Poly(N-methacryl-oyl-6-alanine hydroxamic acid), a polydentate polymer obtained by derivatization of poly(acrylic acid) with pendant hydroxamic acid groups, has shown significant iron chelation activity in vivo (58), a result which is possibly related to the longer retention of polymeric species in the circulatory system. 

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