Biocompatibility of coated and uncoated charcoal during haemoperfusion in healthy dogs.

The biocompatibility of two commercially available charcoal columns, one containing coated and the other uncoated but immobilized charcoal, was compared during four haemoperfusions with each in eight healthy greyhounds. Reductions in arterial levels of platelets (49% and 42% respectively) and leucocytes (both 21%) were similar. Microaggregates, detected by the Swank screen filtration pressure technique, were found in blood leaving the columns during three of the four perfusions with each column. Another twelve perfusions with the uncoated column were carried out with the addition of one or other of the following three agents which inhibit platelet aggregation: sulfinpyrazone, dipyridamole, or citrate-phosphate-dextrose. With none of these were platelet losses less as compared with the four perfusions in which heparin only was used. However, rises in screen filtration pressure were less pronounced. In other perfusions, where its dosage was varied, heparin was shown to reverse, and in large doses delay, the appearance of micro-aggregates. Thrombus in the column itself may be a source of microaggregates, but platelet aggregation in the absence of thrombus deposition may be responsible. The relation of these findings to micro-aggregate formation, which has constituted a clinical problem during charcoal haemoperfusion in humans with fulminant hepatic failure, is considered.