[Extracorporeal adriamycin-removal following hepatic artery infusion: use of direct hemoperfusion combined with veno-venous bypass].
Systemic toxicity of adriamycin (ADR) has limited its high dosage application in hepatic artery infusion. We developed a new extracorporeal device combining direct hemoperfusion (DHP) and veno-venous bypass to eliminate ADR following hepatic artery infusion. Mongrel dogs were divided into three group, I: controls without DHP (n = 3), II: DHP under single venous bypass from IVC to left external jugular vein (n = 3) and III: DHP under hepatic venous isolation using veno-venous bypass (n = 5). Blood specimens were obtained to determine plasma drug levels until 60 min after ADR injection (3 mg/kg body weight, 1 min). Blood flow through DHP, which was averaged 200 ml/min in both groups II and III, was monitored with ultrasonic flowmeter. In groups I and II, peripheral ADR levels rapidly increased, reaching the peak values of 5.61 +/- 2.42 and 1.17 +/- 0.31 micrograms/ml respectively at 1 min after injection. The peak level in group III was markedly reduced, the value being 0.42 +/- 0.17 microgram/ml, which was 7.5% of the peak value of group I. The removal rates in groups II and III were 10.9 and 27.5% respectively. In conclusion, DHP under hepatic venous isolation can be an useful method to reduce systemic distribution of ADR during hepatic artery infusion.
Ku
Y
Y
1st Department of Surgery, Kobe University School of Medicine, Japan.
Saitoh
M
M
Nishiyama
H
H
Fujiwara
S
S
Iwasaki
T
T
Ohyanagi
H
H
Saitoh
Y
Y
D000818:Animals; D004285:Dogs; D004317:Doxorubicin / Q000008:administration & dosage* / Q000097:blood; D005112:Extracorporeal Circulation; D006464:Hemoperfusion / Q000379:methods; D006499:Hepatic Artery; D006503:Hepatic Veins; D007261:Infusions, Intra-Arterial; D007601:Jugular Veins / Q000601:surgery*; D014682:Vena Cava, Inferior / Q000601:surgery*
D004317:Doxorubicin