Flow rate dependence of in vitro removal of anti-A and anti-B antibodies by immunoadsorbents with synthetic oligosaccharides representing blood group substances.

In vitro removal of anti-A and anti-B antibodies by immunoadsorbents with synthetic oligosaccharide structures representing blood group substances have been studied under controlled and simulated extracorporeal perfusion conditions at different flow rates ranging from 20 to 160 mL/min. There is a gradual decline in antibody titers in the plasma, as it relates to the antibody binding capacity and efficiency of the immunoadsorbents, both as a function of time and plasma volume at any of the flow rates employed. Approximately the same maximal binding capacity is achieved in about 4 hours of perfusion regardless of the flow rate, whereas increased number of plasma volumes are required at higher flow rates to compensate for the appropriate residence times needed in the column to utilize the same capacity. The perfusion time alone appears to be a critical factor which via the flow rate determines the residence time between the plasma and the immobilized hapten in the column. Also, the optimal flow rate at which maximum binding capacity of the immunoadsorbent may be utilized efficiently appears to fall within a range of the flow rate. The factors determining this range and the efficiency of the immunoadsorbents under dynamic conditions are discussed. The results obtained under the controlled conditions and the discussions that follow are expected to be generally useful, at least, as approximate clinical guidelines, for selective removal of specific substances by extracorporeal perfusion techniques utilizing therapeutic intervention with immunoadsorbents in this important area of medical therapy.