Direct hemoperfusion by using Lixelle column for the treatment of systemic inflammatory response syndrome.

We have previously reported that Lixelle which was used for beta2-microglobulin (BMG) adsorption column could adsorb not only BMG but also inflammatory cytokines and microbial fragments such as endotoxin (ET) and peptidoglycan (PG). The aim of this study was to estimate that an adsorbent column was used in direct hemoperfusion in patients clinically having systemic inflammatory response syndrome (SIRS), and the relationship between a decrease in cytokines and clinical course was examined. Meanwhile, as regards in vivo rate of removing cytokine based on pre-treatment cytokine concentration versus pre-column concentration at the time of evaluation, it increased with lapse of time, and the removing rate was 40% with 4 h direct hemoperfusion by using the Lixelle column in some of the patients. As to in vivo rates of adsorbing IL-1beta, IL-1Ra, IL-6, IL-8 and TNF-alpha before and after the use of column at the time of evaluation, the rates 5 min after the start were 31.4, 39.3, 36.4, 76.2 and 71.6% respectively. Clinically, it was possible to increase blood pressure and recover from shock status. With the use of this column, removal of inflammatory cytokine by adsorption can be expected. Thus, it can be applied to the treatment of hypercytokinemia.