Protective Effects of Microencapsulation (Coating) on Platelet Depletion and Particulate Embolism in the Clinical Applications of Charcoal Haemoperfusion

  • T. M. S. Chang
Part of the Strathclyde Bioengineering Seminars book series (KESE)


A review of present day applications of the principle of artificial cells commences with a description of the development of the albumin-collodion coated activated charcoal (ACAC) system for haemoperfusion. This is followed by studies of patient safety relating to particulate matter released during perfusion and the consideration of the associated problem of platelet depletion. The review concludes with a discussion of the use of haemoperfusion in chronic renal and liver failure and severe acute drug intoxication.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Amano, I., Iwatsuki, S., Manji, T., Saito, A., Takahira, H., Ohta, K. and Maeda, K. (1976a). Artificial liver assist. Abstract Amer. Soc. Artif. Int. Organs, 5, 3.Google Scholar
  2. Amano, I., Iwatsuki, S., Manji, T., Saito, A., Takahira, H., Ohta, K., and Maeda, K. (1976b). Charcoal haemoperfusion for hepatic encephalopathy. Kidney International (in press).Google Scholar
  3. Asher, W. J., Bovee, K. C., Frankenfeld, J. W., Hamilton, R. W., Henderson, L. W., Holtzapple, P. G., and Li, N. N. (1975). Liquid membrane system directed toward chronic uraemia. Kidney International, 7, S409.Google Scholar
  4. Baltzer, G. (1976). Neue Wage in der Behandlung akuter Intoxikationen. Der Internist, 17, 322–323.PubMedGoogle Scholar
  5. Barbour, B. (1976). Fixed bed charcoal haemoperfusion for acute drug intoxication. Kidney International (in press).Google Scholar
  6. Blume, U., Helmstaedt, D., Sybrecht, G., Baldamus, C., Sussman, P., Heyer, U., Schmidt, E., Schmidt, E. (1976). Hämperfusionstherapie des akuten Leberversagens. Dtsch. Med. Wschr., 14, 559.Google Scholar
  7. Carvallo, A., Ramirez, B., Honig, H., Knepshield, J., Schreiner, G. E. and Gelfand, M. C. (1976). Treatment of digitalis intoxication by charcoal haemoperfusion. Abstract Amer. Soc. Artif. Int. Organs, 5, 14.Google Scholar
  8. Chang, T. M. S. (1964). Semipermeable microcapsules. Science, 146, 524.Google Scholar
  9. Chang, T. M. S. (1966). Semipermeable aqueous microcapsules (artificial cells) with emphasis on experiments in an extracorporeal shunt system. Trans. Amer. Soc. Artif: Int. Organs, 12, 13.Google Scholar
  10. Chang, T. M. S. (1969). Removal of endogenous and exogenous toxins by a micro-encapsulated adsorbent. Can. J. Physiol. Pharm., 47, 1043.CrossRefGoogle Scholar
  11. Chang, T. M. S. (1972a). Artificial Cells, Thomas, Springfield, Illinois, USA. Chang, T. M. S. (1972b). Haemoperfusions over microencapsulated adsorbent in a patient with hepatic coma. Lancet, 2, 1371.PubMedCrossRefGoogle Scholar
  12. Chang, T. M. S. (1972c). Recent trends in biocompatible materials and microcapsular absorbents for kidney function replacement, in R. M. Kenedi (Ed.) Perspectives in Biomedical Engineering, Macmillan Press, London.Google Scholar
  13. Chang, T. M. S. (1974). Platelet-surface interaction: Effect of albumin coating or heparin complexing on thrombogenic surfaces. Can. J. Physiol. Pharm., 52, 275.CrossRefGoogle Scholar
  14. Chang, T. M. S. (1975a). Microencapsulated adsorbent haemoperfusion for uremia, intoxication, and hepatic failure. Kidney International, 7, S387.Google Scholar
  15. Chang, T. M. S. (1975b). Experience with treatment of acute liver failure patients by haemoperfusion over biocompatible microencapsulated (coated) charcoal, in R. Williams and I. M. Murray-Lyon (Eds.), Artificial Liver Support, Pitman Medical, London, p. 229.Google Scholar
  16. Chang, T. M. S. (1976a). Microcapsule artificial kidney including updated preparative procedures and properties. Kidney International (in press).Google Scholar
  17. Chang, T. M. S. (1976b). Haemoperfusion alone and in series with ultrafiltration or dialysis for uraemia, poisoning, and liver failure. Kidney International (in press).Google Scholar
  18. Chang, T. M. S. (1977). Biomedical Applications of Immobilized Enzymes and Proteins Plenum, New York.CrossRefGoogle Scholar
  19. Chang, T. M. S. and Loa, S. K. (1970). Urea removal by urease and ammonia adsorbent in the intestine. Physiologist, 13, 70.Google Scholar
  20. Chang, T. M. S. and Malave, N. ( 1970. The development and first clinical uses of semi-permeable microcapsules (artificial cells) as a compact artificial kidney. Trans. Amer. Soc. Artif. Int. Organs, 16, 141.Google Scholar
  21. Chang, T. M. S. and Migchelsen, M. (1973). The characterization of possible `toxic’ metabolites in patients with chronic renal failure and hepatic coma. Trans. Amer. Soc. Artif. Int. Organs, 19, 314.CrossRefGoogle Scholar
  22. Chang, T. M. S., Pont, A., Johnson, L. J. and Malave, N. (1968). Response to intermittent extracorporeal perfusion through shunts containing semipermeable microcapsules. Trans. Amer. Soc. Artif Int. Organs, 15, 163.Google Scholar
  23. Chang, T. M. S., Gonda, A., Dirks, J. and Malave, N. (1971). Clinical evaluation of chronic intermittent or short-term haemoperfusion in patients with chronic renal failure using semipermeable microcapsules (artificial cells) formed from membrane coated activated charcoal. Trans. Amer. Soc. Artif Int. Organs, 17, 246.Google Scholar
  24. Chang, T. M. S., Gonda, A., Coffey, J., Dirks, J. and Burns, T. (1972). ACAC microcapsule artificial kidney for long-term and short-term management of patients with chronic renal failure. Trans. Amer. Soc. Artif Int. Organs, 18, 465.CrossRefGoogle Scholar
  25. Chang, T. M. S., Coffey, J. F., Barre, P., Gonda, A., Dirks, J. H., Levy, M., and Lister, C. (1973a). Microcapsule artificial kidney: treatment of patients with acute drug intoxication. Can. Med. Assoc. J., 108, 429.PubMedPubMedCentralGoogle Scholar
  26. Chang, T. M. S., Coffey, J. F., Lister, C., Stark, R. and Taroy, E. (1973b). The clearance of the ACAC microcapsule artificial kidney for glutethimide, methprylon, and methaqualone: in vitro and in patients. Trans. Amer. Soc. Artif Int. Organs, 19, 87.CrossRefGoogle Scholar
  27. Chang, T. M. S., Migchelsen, M., Coffey, J. F., and Stark, R. (1974). Serum middle molecule levels in uraemia during long-term intermittent haemoperfusion with the ACAC (coated charcoal) microcapsule artificial kidney. Trans. Amer. Soc. Artif. Int. Organs, 20 (A), 354.Google Scholar
  28. Chang, T. M. S., Chirito, E., Barre, P., Cole, C., Hewish, M. (1975). Clinical performance characteristics of a new combined system for simultaneous haemoperfusion -haemodialysis -ultrafiltration in series. Trans. Amer. Soc. Artif Int. Organs, 21, 502.Google Scholar
  29. Chang, T. M. S., Chirito, E., Barre, P.,Cole, C., Lister, C. and Resurrection, E. (1976). Clinical evaluation of the clearance profiles of a portable, compact, dialysate -free system incorporating microencapsulated charcoal haemoperfusion for blood purification with ultrafiltration for fluid removal. J. Dialysis (in press).Google Scholar
  30. Demyttenaere, M. H., Maher, J. F. and Schreiner, G. E. (1967). Haemoperfusion through a charcoal column for glutethimide poisoning. Trans. Amer. Soc. Artif Int. Organs, 13, 190.Google Scholar
  31. Dunea, G. and Kolff, W. J. (1965). Clinical experiments with the Yatzidis charcoal artificial kidney. Trans. Amer. Soc. Artif. Int. Organs, 11, 178.CrossRefGoogle Scholar
  32. Dunea, G., Rizvi, Z. H., Mamdaru, B. H., Anicama, H. J. and Mahurkar, S. D. (1976). Charcoal haemoperfusion and combination dialysis-haemoperfusion in chronic renal failure. Abstract Amer. Soc. Artif. Int. Organs, 5, 22.Google Scholar
  33. Friedman, E. A., Laugani, G. B. and Beyer, M. M. (1975). Life prolongation in nephrectomized rats fed oxidized starch and charcoal. Kidney International, 7, S377.Google Scholar
  34. Gardner, D. L., Emmerling, D. C., Williamson, D. W., Baytos, W. C. and Hassler, C. R. (1975). Encapsulated adsorbents for removal of nitrogenous metabolites via oral ingestion. Kidney International, 7, S393.Google Scholar
  35. Gazzard, B. G., Weston, M. J., Murray-Lyon, I. M., Flax, H., Record, C. O., Portman, B., Langley, P. G., Dunlop, E. H., Mellon, P. J., Ward, M.D. and Williams, R. (1974). Charcoal haemoperfusion in the treatment of fulminating hepatic failure. Lancet, 1 (7870), 1301.PubMedCrossRefGoogle Scholar
  36. Giordano, C., Esposito, R. and Pluvio, M. (1975). Oxycellulose and ammonia-treated oxystarch as insoluble polyaldehydes. Kidney International, 7, S380.CrossRefGoogle Scholar
  37. Hagstam, K. E., Larsson, L. E. and Thysell, H. (1966). Experimental studies on charcoal haemoperfusion in phenobarbital intoxication and uremia including histological findings. Acta. Med. Scand., 180, 593.PubMedCrossRefGoogle Scholar
  38. Hill, J. B. (1975). B-D haemo-detoxification systems. Pamphlet from Becton, Dickinson, & Co, Research Centre, North Carolina, pp. 1–4.Google Scholar
  39. Lesch, P., Blume, V., Scheibe, G., Sussmann, P., Schmidt, F. W., Bartels, M., and Okonek, S. (1976). Haemoperfusion durch verkapselte Aktivkolile Zur Therapie Exogener and endogener Intoxikationen. Klin. Wschr., 54, 509.CrossRefGoogle Scholar
  40. Martin, A. M., Mitchell, D. C., Gibbins, J. K., Devapal, D., Trinder, P. (1975). Charcoal haemoperfusion in the management of severe poisoning. Brit. Med. J., 1 (5948), 5.CrossRefGoogle Scholar
  41. Nosé, Y., Koshino, I., Castino, F., Yoshida, K., Carse, G., Kambic, H., Scheucher, K., Kretx, A. P. and Malchesky, P. S. (1975). Further assessment of liver tissue materials for extracorporeal hepatic assists, in R. Williams and I. M. Murray-Lyon (Eds.), Artificial Liver Support, Pitman Medical, London, p. 202.Google Scholar
  42. Plotz, P. H., Berk, P. D., Scharschmidt, B. T., Gordon, J. K. and Vergalla, J. (1974). Removal of bilirubin by albumin-coated conjugated agarose beads. J. Clin. Invest., 53, 778.PubMedPubMedCentralCrossRefGoogle Scholar
  43. Rosenbaum, J. L. (1975). Biocompatibility of resin haemoperfusion, in R. Williams and I. M. Murray-Lyon (Eds.), Artificial Liver Support, Pitman Medical, London, pp. 118.Google Scholar
  44. Silverstein, M. D., Ford, C. A., Lysaght, M. J. and Henderson, C. W. (1974).Treatment of severe fluid overload by ultrafiltration. New Engl. J. Med. 291 747.PubMedCrossRefGoogle Scholar
  45. Sparks, R. E. (1975). Gastrosorbents in the therapy of uraemia: Inferences from intestinal loop dialysis. Kidney International, 7, S373.Google Scholar
  46. Vale, J. A., Rees, A. J., Widdop, B., and Goulding, R. (1975). The use of charcoal haemoperfusion in the maintenance of severely poisoned patients. Brit. Med. J., 1 (5948), 5.PubMedPubMedCentralCrossRefGoogle Scholar
  47. Van Wagenen, R. A., Steggall, M., Lentz, D. J. and Andrade, J. D. (1975). Activated carbons for medical applications. In vitro microparticle characterisation and solute adsorption. Biomat. Med. Dev. Artif Organs, 3, 319.Google Scholar
  48. Watson, W. J. and Chang, T. M. S. (1975). Platelet -surface interaction: Effects of Dextran 70 on platelet retention in extracorporeal surfaces. Biomat. Med. Dev. Artif. Organs, 3 (4), 489.Google Scholar
  49. Weston, M. J. (1975). Discussion, in Conference on Sorbents in Uraemia, Downstate Medical Centre, Brooklyn, New York, November 3–4, 1975.Google Scholar
  50. Winchester, J. F., Tilstone, W. J., Edwards, R. O., Gilchrist, T. and Kennedy, A. C. (1974). Haemoperfusion for enhanced drug elimination — a kinetic analysis in paracetamol poisoning. Trans. Amer. Soc. Artif Int. Organs, 20, 358.Google Scholar
  51. Winchester, J. F., Apiliga, M. T., MacKay, J. M., Kennedy, A. C. (1975). Haemodialysis with charcoal haemoperfusion. Proc. Eur. Dial. Transpl. Assoc., 12, 526.Google Scholar
  52. Yatzidis, D. (1964). A convenient haemoperfusion micro-apparatus over charcoal for the treatment of endogenous and exogenous intoxications. Its use as an effective artificial kidney. Proc. Eur. Dial. Transpl. Assoc., 1, 83.Google Scholar

Copyright information

© Bioengineering Unit, University of Strathclyde 1977

Authors and Affiliations

  • T. M. S. Chang

There are no affiliations available

Personalised recommendations