Bile acid clearance and biocompatibility of XAD-4 haemoperfusion

The clearance of bile acids from human blood or human albumin solutions obtained by perfusion through 100 g XAD-4 at 100 ml/min was (in ml/min): 21 for taurocholic acid, 3 for taurochenodeoxycholic acid, 18 for glycholic acid and 2 for glychenodeoxycholic acid. Saturation effects were absent up to 7 mumole bile acid bound per gram XAD-4. Haemoperfusion (100 g XAD-4, 100 ml/min) of cholestatic dogs resulted in the removal of up to 400 mumole bile acid in 3 hours. The calculated amount of bile acid stored in tissue depots was large with respect to the amount present in the circulation. A steady state between the mobilization of the tissue pool of bile acids and the removal of bile acids from the blood was established during the perfusion. Measurements of electrolytes enzyme activities and cellular elements showed severe losses of thrombocytes and leucocytes only. Contact with XAD-4 was the cause of the platelet loss where as omission of the resin from the perfusion system did not effect the leucocyte loss. The thrombocyte loss was reduced by the addition of citrate. Differentiation of the leucocytes showed that primarily the segmental granulocytes were sequestrated.