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Platelet function during haemoperfusion in acute liver failure.

R D Hughes, D A Lane, G Cella

    The International Journal of Artificial Organs
    |January 1, 1980
    PubMed
    Summary
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    Albumin-coated resin haemoperfusion is more blood-compatible for platelets than charcoal haemoperfusion. Beta-thromboglobulin levels indicate platelet activation during the procedure.

    Area of Science:

    • Hematology
    • Hepatology
    • Biomaterials

    Background:

    • Acute liver failure (ALF) necessitates advanced treatments like haemoperfusion.
    • Assessing haemoperfusion's impact on haemostatic parameters is crucial for patient safety.
    • Platelet activation is a key concern during extracorporeal circuits.

    Purpose of the Study:

    • To compare the effects of albumin-coated resin and polymer-coated charcoal haemoperfusion on platelet-related haemostatic parameters in ALF patients.
    • To evaluate beta-thromboglobulin as a marker for platelet activation during haemoperfusion.
    • To determine the blood compatibility of different haemoperfusion columns.

    Main Methods:

    • Eleven ALF patients underwent haemoperfusion using either albumin-coated resin (n=5) or polymer-coated charcoal (n=6) columns.

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  • Platelet and white cell counts were monitored.
  • Beta-thromboglobulin levels and screen filtration pressure were measured.
  • Heparin consumption was also assessed.

    • Main Results:

    • Both columns showed minimal platelet and white cell loss over four hours.
    • Charcoal haemoperfusion led to significant increases in beta-thromboglobulin (mean 341 ng/ml) after one hour.
    • One patient on charcoal experienced severe hypotension and elevated beta-thromboglobulin (860 ng/ml).
    • One patient on resin showed rapid heparin consumption.

    Conclusions:

    • Beta-thromboglobulin is a sensitive indicator of platelet activation during haemoperfusion.
    • Albumin-coated resin haemoperfusion demonstrates superior blood compatibility regarding platelet interaction compared to charcoal haemoperfusion.
    • These findings suggest albumin-coated resin columns may offer a safer option for ALF patients requiring haemoperfusion.