Clinical evaluation of the clearance profiles of a portable, compact, dialysate-free system incorporating microencapsulated charcoal hemoperfusion for blood purification with ultrafiltration for fluid removal.

A total of 30 procedures have been carried out in two patients using a new portable, compact, dialysate-free system formed by combining 300 gms of albumin--cellulose nitrate microencapsulated activated charcoal (ACAC) in series with a small Amicon ultrafiltrator. Blood passing through the ACAC hemoperfusion system is purified of waste metabolites and toxins. Fluid removal is carried out with the hydrostatic pressure of the blood passing through the dialysate-free ultrafiltrator. Since ACAC hemoperfusion is much more efficient than hemodialysers for blood purification, the combined system with the ultrafiltrator results in a very efficient system for blood purification and fluid removal. Typical clearance data for the combined systems include: 75 ml/min for 2000--5000 MW; 112.7 ml/min for 300--1500 MW; 235 ml/min for creatinine; 240 ml/min for uric acid; 2500--2700 ml/2 hours for water removal; and 17--18 gm/2 hours for NaCl removal. Guanidines, mercaptans, and PTH are also cleared very efficiently.