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Abstracts: ASAIO Bioengineering/tissue Engineering Abstracts

ENHANCING IN VITRO CLEARANCE OF SMALL MOLECULE TOXINS USING A NOVEL CVVH-BASED RECIRCULATION LOOP: IMPLICATIONS FOR BAL SUPPORT AND RENAL REPLACEMENT THERAPY

Linde, Peter G1,2; Von Visger, Jon R1,2; Maxwell, Kameron3; Brotherton, John D3; Conlin, Carol3; Cosimi, Anthony B2; Williams, Winfred W1,2

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Bioartificial liver (BAL) support systems remove toxins from the patient’s blood stream. We present in vitro data which compares the abilities of two continuous veno-venous hemofiltration-based systems which can be integrated into a BAL support system to effect ammonia clearance: A) single-pass CVVH and B) a recirculation-based CVVH loop system (pictured below). Using a “patient” carboy as an ammonia source, we ran in each system CVVH at a replacement rate of 3200 cc/hour. We found that single-pass CVVH yielded an average ammonia clearance of 43.7 +/− 2.6 cc/min, whereas the recirculation loop yielded a 28 % increase in clearance at 56.1 +/− 2.9 cc/min. This improvement in ammonia clearance likely carries over to other small molecules such as urea, creatinine and lactic acid. These data suggest that higher clearance rates of liver and uremic toxins can be attained with limited blood flow rates. We hypothesize that loop technology could increase small and middle molecule clearance in CVVH or standard hemodialysis.

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Copyright © 2005 by the American Society for Artificial Internal Organs