Skip to main content
SpringerLink
Log in

Sorbents, Hemoperfusion Devices

  • Chapter
  • First Online:
Core Concepts in Dialysis and Continuous Therapies

  • 1803 Accesses

Abstract

This chapter discusses the multiple uses to which sorbents have been put in modern medicine. They range from the simple ingestion of sorbents to remove substances such as uremic toxins, electrolytes, and drugs, to modifications of dialysis circuits by placing sorbent devices in line, to complex devices employing plasmapheresis to expose plasma to sorbents (avoiding blood cell exposure), to novel uses of sorbent systems to remove antibodies, cytokines, and viruses from biological fluids. Many of the devices are in clinical trial, but many are available in Europe and Japan for clinical use.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Davenport A, Ronco C, Gura V. From wearable ultrafiltration device to wearable artificial kidney. Contrib Nephrol. 2011;171:237–42.

    Article  CAS  PubMed  Google Scholar 

  2. Formica M, Inguaggiato P, Bainotti S, Wratten ML. Coupled plasma filtration adsorption. Contrib Nephrol. 2007;156:405–10.

    Article  PubMed  Google Scholar 

  3. Bellomo R, Honoré PM, Matson J, Ronco C, Winchester J. Extracorporeal blood treatment (EBT) methods in SIRS/Sepsis. Int J Artif Organs. 2005;28:450–8.

    CAS  PubMed  Google Scholar 

  4. Uribarri J. Personal communication. 2014.

    Google Scholar 

  5. Shalkham AS, Kirrane BM, Hoffman RS, Goldfarb DS, Nelson LS. The availability and use of charcoal hemoperfusion in the treatment of poisoned patients. Am J Kidney Dis. 2006;48:239–41.

    Article  PubMed  Google Scholar 

  6. Holubek WJ, Hoffman RS, Goldfarb DS, Nelson LS. Use of hemodialysis and hemoperfusion in poisoned patients. Kidney Int. 2008;74(10):1327–34.

    Article  CAS  PubMed  Google Scholar 

  7. Mowry JB, Spyker DA, Cantilena LR Jr, Bailey JE, Ford M. 2012 Annual Report of the American Association of Poison Control Centersʼ National Poison Data System (NPDS): 30th Annual Report. Clin Toxicol (Phila). 2013;51:949–1229.

    Article  CAS  Google Scholar 

  8. Palmer BF. Effectiveness of hemodialysis in the extracorporeal therapy of phenobarbital overdose. Am J Kidney Dis. 2000;36:640–3.

    Article  CAS  PubMed  Google Scholar 

  9. Mactier R, Laliberté M, Mardini J, Ghannoum M, Lavergne V, Gosselin S, Hoffman RS, Nolin TD, EXTRIP Workgroup. Extracorporeal treatment for barbiturate poisoning: recommendations From the EXTRIP workgroup. Am J Kidney Dis. 2014;64:347–58.

    Article  PubMed  Google Scholar 

  10. Lavergne V, Nolin TD, Hoffman RS, Roberts D, Gosselin S, Goldfarb DS, Kielstein JT, Mactier R, Maclaren R, Mowry JB, Bunchman TE, Juurlink D, Megarbane B, Anseeuw K, Winchester JF, Dargan PI, Liu KD, Hoegberg LC, Li Y, Calello DP, Burdmann EA, Yates C, Laliberté M, Decker BS, Mello-Da-Silva CA, Lavonas E, Ghannoum M. The EXTRIP (EXtracorporeal TReatments In Poisoning) workgroup: guideline methodology. Clin Toxicol (Phila). 2012;50:403–13.

    Google Scholar 

  11. Ghannoum M, Bouchard J, Nolin TD, Ouellet G, Roberts DM. Hemoperfusion for the treatment of poisoning: technology, determinants of poison clearance, and application in clinical practice. Semin Dial. 2014;27:350–61.

    Article  PubMed  Google Scholar 

  12. Winchester JF, Harbord NB, Charen E, Ghannoum M. Use of dialysis and hemoperfusion, in treatment of poisoning. In: Daugirdas JT, Blake PG, Todd SI, editors. Handbook of dialysis. 5th edn. Philadelphia: Lippincott Willliams & Wilkins; 2015. p. 368–90.

    Google Scholar 

  13. Yates C, Galvao T, Sowinski KM, Mardini K, Botnaru T, Gosselin S, Hoffman RS, Nolin TD, Lavergne V, Ghannoum M, EXTRIP Workgroup. Extracorporeal treatment for tricyclic antidepressant poisoning: recommendations from the EXTRIP Workgroup. Semin Dial. 2014;27:381–9.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Terman DS, Stewart I, Robinette J, Carr R, Harbeck R. Specific removal of DNA antibodies in vivo with an extracorporeal immuno-adsorbent. Clin Exp Immunol. 1976;24:231–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Alarabi AA, Wikström B, Backman U, Danielson BG, Tufvesson G, Sjöberg O. Pretransplantation immunoadsorption therapy in patients immunized with human lymphocyte antigen: effect of treatment and three yearsʼ clinical follow-up of grafts. Artif Organs. 1993;17:702–7.

    Article  CAS  PubMed  Google Scholar 

  16. Keven K, Sengul S, Celebi ZK, Tuzuner A, Yalcin F, Duman T, Tutkak H. Kidney transplantation in immunologically high-risk patients. Transplant Proc. 2013;45:919–22.

    Article  CAS  PubMed  Google Scholar 

  17. Teruya A, Kawamura K, Ichikado K, Sato S, Yasuda Y, Yoshioka M. Successful polymyxin B hemoperfusion treatment associated with serial reduction of serum anti-CADM-140/MDA5 antibody levels in rapidly progressive interstitial lung disease with amyopathic dermatomyositis. Chest. 2013;144:1934–6.

    Article  CAS  PubMed  Google Scholar 

  18. Stummvoll GH, Schmaldienst S, Smolen JS, Derfler K, Biesenbach P. Lupus nephritis: prolonged immunoadsorption (IAS) reduces proteinuria and stabilizes global disease activity. Nephrol Dial Transpl. 2012;27:618–26.

    Article  CAS  Google Scholar 

  19. Herrero-González JE, Brauns O, Egner R, Rönspeck W, Mascaró JM Jr, Jonkman MF, Zillikens D, Sitaru C. Immunoadsorption against two distinct epitopes on human type XVII collagen abolishes dermal-epidermal separation induced in vitro by autoantibodies from pemphigoid gestationis patients. Eur J Immunol. 2006;36:1039–48.

    Article  PubMed  Google Scholar 

  20. Dandel M, Wallukat G, Englert A, Hetzer R. Immunoadsorption therapy for dilated cardiomyopathy and pulmonary arterial hypertension. Atheroscler Suppl. 2013;14:203–11.

    Article  CAS  PubMed  Google Scholar 

  21. Rönspeck W, Brinckmann R, Egner R, Gebauer F, Winkler D, Jekow P, Wallukat G, Müller J, Kunze R. Peptide based adsorbers for therapeutic immunoadsorption. Ther Apher Dial. 2003;7:91–7.

    Article  PubMed  Google Scholar 

  22. Genberg H, Kumlien G, Wennberg L, Berg U, Tydén G. ABO-incompatible kidney transplantation using antigen-specific immunoadsorption and rituximab: a 3-year follow-up. Transplantation. 2008;85:1745–54.

    Article  CAS  PubMed  Google Scholar 

  23. Genberg H, Kumlien G, Wennberg L, Tyden G. The efficacy of antigen-specific immunoadsorption and rebound of anti-A/B antibodies in ABO-incompatible kidney transplantation. Nephrol Dial Transpl. 2011;26:2394–400.

    Article  CAS  Google Scholar 

  24. Donauer J, Wilpert J, Geyer M, Schwertfeger E, Kirste G, Drognitz O, Walz G, Pisarski P. ABO-incompatible kidney transplantation using antigen-specific immunoadsorption and rituximab: a single center experience. Xenotransplantation. 2006;13:108–10.

    Article  PubMed  Google Scholar 

  25. Braun N, Gutenberger S, Erley CM, Risler T. Immunoglobulin and circulating immune complex kinetics during immunoadsorption onto protein A sepharose. Transfus Sci. 1998;19 Suppl:25–31.

    CAS  PubMed  Google Scholar 

  26. Koch M1, Kohnle M, Trapp R. A case report of successful long-term relapse control by protein-a immunoadsorption in an immunosuppressive-treated patient with end-stage renal disease due to Wegenerʼs granulomatosis. Ther Apher Dial. 2009;13:150–6.

    Article  PubMed  Google Scholar 

  27. Kandus A, Ponikvar R, Buturović-Ponikvar J, Bren AF, Oblak M, Mlinšek G, Kmetec A, Arnol M. Plasmapheresis and immunoadsorption for treatment and prophylaxis of recurrent focal segmental glomerulosclerosis in adult recipients of deceased donor renal grafts. Ther Apher Dial. 2013;17:438–43.

    Article  CAS  PubMed  Google Scholar 

  28. Sawada K, Malchesky PS, Koo AP, Mitsumoto H. Myasthenia gravis therapy: immunoadsorbent may eliminate need for plasma products. Cleve Clin J Med. 1993;60:60–4.

    Article  CAS  PubMed  Google Scholar 

  29. Jiménez C1, Rosenow F, Grieb P, Haupt WF, Borberg H. Adsorption therapy with tryptophan-conjugated polyvinyl alcohol gels in 10 patients with acute Guillain-Barré syndrome. Transfus Sci. 1993;14:9–11.

    Article  PubMed  Google Scholar 

  30. Ikeda U, Kasai H, Izawa A, Koyama J, Yazaki Y, Takahashi M, Higuchi M, Koh CS, Yamamoto K. Immunoadsorption therapy for patients with dilated cardiomyopathy and heart failure. Curr Cardiol Rev. 2008;4:219–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Koziolek MJ, Tampe D, Bähr M, Dihazi H, Jung K, Fitzner D, Klingel R, Müller GA, Kitze B. Immunoadsorption therapy in patients with multiple sclerosis with steroid-refractory optical neuritis. J Neuroinflammation. 2012;9:80–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Fadul JEM, Danielson BG, Wistron B. Reduction of plasma fibrinogen, immunoglobulin G, and immunoglobulin M concentrations by immunoadsorption therapy with tryptophan and phenylalanine adsorbents. Artif Org. 1996;20:986–90.

    Google Scholar 

  33. Pfueller B, Wolbart K, Bruns A, Burmester GR, Hiepe F. Successful treatment of patients with systemic lupus erythematosus by immunoadsorption with a C1q column: a pilot study. Arthritis Rheum. 2001;44:1962–3.

    Article  CAS  PubMed  Google Scholar 

  34. Hiepe F, Pfüller B, Wolbart K, Bruns A, Leinenbach HP, Hepper M, Schössler W, Otto V. C1q: a multifunctional ligand for a new immunoadsorption treatment. Ther Apher. 1999;3:246–51.

    Article  CAS  PubMed  Google Scholar 

  35. Felson DT, LaValley MP, Baldassare AR, Block JA, Caldwell JR, Cannon GW, Deal C, Evans S, Fleischmann R, Gendreau RM, Harris ER, Matteson EL, Roth SH, Schumacher HR, Weisman MH, Furst DE. The Prosorba column for treatment of refractory rheumatoid arthritis: a randomized double-blind, sham-controlled trial. Arthritis Rheum. 1999;42:2153–9.

    Article  CAS  PubMed  Google Scholar 

  36. Stefanutti C, Di Giacomo S, Mareri M, De Lorenzo F, DʼAlessandri G, Angelico F, Bucci A, Musca A, Mammarella A. Immunoadsorption apheresis (Selesorb) in the treatment of chronic hepatitis C virus-related type 2 mixed cryoglobulinemia. Transfus Apher Sci. 2003;28:207–14.

    Article  CAS  PubMed  Google Scholar 

  37. Matsuki Y1, Suzuki K, Kawakami M, Ishizuka T, Hidaka T, Nakamura H. Adsorption of anaphylatoxins from the plasma of systemic lupus erythematosus patients using dextran sulfate cellulose columns. J Clin Apher. 1998;13:108–13.

    Article  CAS  PubMed  Google Scholar 

  38. Chang TM, Malave N. The development and first clinical use of semipermeable microcapsules (artificial cells) as a compact artificial kidney. Trans Am Soc Artif Intern Organs. 1970;16:141–8.

    CAS  PubMed  Google Scholar 

  39. Winchester JF, Ratcliffe JG, Carlyle E, Kennedy AC. Solute, amino acid, and hormone changes with coated charcoal hemoperfusion in uremia. Kidney Int. 1978;14:74–81.

    Google Scholar 

  40. Yamamoto Y, Hirawa N, Yamaguchi S, Ogawa N, Takeda H, Shibuya K, Kawahara K, Kojima H, Dobashi Y, Fujita M, Azusima K, Miyazaki N, Kobayashi M, Kobayashi C, Fujiwara A, Yuto J, Saka S, Yatsu K, Toya Y, Yasuda G, Ohnishi T, Umemura S. Long-term efficacy and safety of the small-sized β2-microglobulin adsorption column for dialysis-related amyloidosis. Ther Apher Dial. 2011;15:466–74.

    Article  CAS  PubMed  Google Scholar 

  41. Winchester JF, Silberzweig J, Ronco C, Kuntsevich V, Levine D, Parker T, Kellum JA, Salsberg JA, Quartararo P, Levin NW. Sorbents in acute renal failure and end stage renal disease: middle molecule and cytokine removal. Blood Purif. 2004;22:73–7.

    Article  CAS  PubMed  Google Scholar 

  42. Kobe Y, Oda S, Matsuda K, Nakamura M, Hirasawa H. Direct hemoperfusion with a cytokine-adsorbing device for the treatment of persistent or severe hypercytokinemia: a pilot study. Blood Purif. 2007;25:446–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Hetz H, Berger R, Recknagel P, Steltzer H. Septic shock secondary to β[beta]-hemolytic streptococcus-induced necrotizing fasciitis treated with a novel cytokine adsorption therapy. Int J Artif Organs. 2014;37:422–6.

    Google Scholar 

  44. Atan R, Crosbie DC, Bellomo R. Techniques of extracorporeal cytokine removal: a systematic review of human studies. Ren Fail. 2013;35:1061–70.

    Google Scholar 

  45. Haase M, Bellomo R, Baldwin I, Haase-Fielitz A, Fealy N, Davenport P, Morgera S, Goehl H, Storr M, Boyce N, Neumayer HH. Hemodialysis membrane with a high-molecular-weight cutoff and cytokine levels in sepsis complicated by acute renal failure: a phase 1 randomized trial. Am J Kidney Dis. 2007;50:296–304.

    Google Scholar 

  46. Tullis RH, Duffin RP, Ichim TE, Joyce JA, Levin NW. Modeling hepatitis C virus therapies combining drugs and lectin affinity plasmapheresis. Blood Purif. 2010;29:210–5.

    Google Scholar 

  47. Ichim TE, Zhong Z, Kaushal S, Zheng X, Ren X, Hao X, Joyce JA, Hanley HH, Riordan NH, Koropatnick J, Bogin V, Minev BR, Min WP, Tullis RH. Exosomes as a tumor immune escape mechanism: possible therapeutic implications. J Transl Med. 2008;6:37.

    Google Scholar 

  48. Tateishi J, Kitamoto T, Mohri S, Satoh S, Sato T, Shepherd A, Macnaughton MR. Scrapie removal using Planova virus removal filters. Biologicals. 2000;29:17–25.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine and Division of Nephrology and Hypertension, Mount Sinai Beth Israel/Icahn School of Medicine at Mount Sinai, New York, NY, USA

    James F. Winchester M.D., Nikolas B. Harbord M.D. & Elliot Charen M.D.

Authors
  1. James F. Winchester M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nikolas B. Harbord M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elliot Charen M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to James F. Winchester M.D. .

Editor information

Editors and Affiliations

  1. Department of Nephrology, Beaumont Hospital, Dublin, Dublin, Ireland

    Colm C. Magee

  2. Department of Medicine/Renal Division, Brigham and Women's Hospital, BOSTON, Massachusetts, USA

    J. Kevin Tucker

  3. Global and Continuing Education, Harvard Medical School, Boston, Massachusetts, USA

    Ajay K. Singh

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Winchester, J., Harbord, N., Charen, E. (2016). Sorbents, Hemoperfusion Devices. In: Magee, C., Tucker, J., Singh, A. (eds) Core Concepts in Dialysis and Continuous Therapies. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7657-4_22

Download citation

  • DOI: https://doi.org/10.1007/978-1-4899-7657-4_22

  • Published:

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-7655-0

  • Online ISBN: 978-1-4899-7657-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation