Metabolic inhibition of polymorphonuclear leucocytes in fulminant hepatic failure.

A high incidence of bacterial infections in patients with fulminant hepatic failure (F.H.F.) has led to an investigation of polymorpho-nuclear-leucocyte (P.M.N.) function. No intrinsic leucocyte abnormality was demonstrable but a factor present in F.H.F. serum was shown to inhibit the metabolic activity of the leucocyte hexose-monophosphate shunt. This effect was due neither to low serum-complement nor to associated renal failure. The inhibitory factor, however, was removed either by pre-incubation with activated charcoal or by in-vitro dialysis, raising the possiblity that charcoal haemoperfusion or other forms of artificial liver support may improve P.M.N. function in this condition.