Removal of alpha-amanitin from blood by hemoperfusion over uncoated charcoal. Experimental results

The sorbent capacity of uncoated charcoal column (Detoxyl 2, Sorin Biomedica) on alpha-amanitin was studied by adding known amounts of alpha-amanitin to fresh human blood, which was recirculated through a clinical hemoperfusion circuit over a period of 30 min. The column was washed with saline to remove loosely bound alpha-amanitin, and eluted with 0.1 N HCl to detach absorbed alpha-amanitin. Alpha-amanitin concentration was measured in the saline washings and in the acid eluates by means of a radioimmunoassay. Only negligible amounts of amanitin were recovered in the saline washings. Suitable amounts of alpha-amanitin were present in the acid eluates, showing an adsorption optimum for blood concentrations ranging from 50 to 200 ng . ml-1. The results were discussed as predictable of the clinical usefulness of charcoal hemoperfusion in A. phalloides poisoning.