HEMOPERFUSION THROUGH ALBUMIN-CONJUGATED AGAROSE-GEL FOR TREATMENT OF NEONATAL JAUNDICE IN PREMATURE RHESUS-MONKEYS

Abstract

Hemoperfusion through albumin-conjugated agarose gel (AAG) effectively removes bilirubin (BR) and other albumin-bound materials from whole blood or plasma. This technique was to treat neonatal jaundice in premature rhesus monkeys with a specially designated apparatus which permitted continuous perfusion through 1 of 4 columns arranged in parallel while the others are sequentially washed with saline and regenerated with ethanol. Less than 15% of the animal''s blood volume was required in the extracorporeal circuit at any time. Compared with 5 control monkeys which had a peak BR concentration ([BR]) averaging approximately 4 mg/100 ml, 6 experimental monkeys showed a significant (P < 0.01) reduction, averaging 60%, in [BR] after each of 2 perfusions at approximately 20 and 26 h of age. AAG hemoperfusion was even more effective in lowering [BR] in monkeys with higher preperfusion concentrations produced by BR infusion (average reduction = 68 and 87% at preperfusion concentrations of 11.9 and 24.2 mg/100 ml, respectively). BR eluted from the column averaged 93% of the estimated preperfusion plasma BR pool. Unlike previous studies in rats, perfused monkeys showed significant platelet losses, although it was possible to prevent these losses by the use of "regional citrate" during perfusion. AAG hemoperfusion was seemingly effective in the treatment of neonatal jaundice, although potential problems such as sterility and platelet loss need further evolution before it can be considered for human use.