Platelet function during haemoperfusion in acute liver failure

Abstract

The changes in platelet-related haemostatic parameters have been studied during haemoperfusion of eleven patients with acute liver failure. Five patients were treated by haemoperfusion with an albumin-coated resin column and six with a polymer-coated charcoal column. The platelet and white cell losses over four hours’ haemoperfusion were small in both groups. Significant increases in β-thromboglobulin (mean 341 ± SE 145 ng/ml) were seen after one hour in the patients treated by charcoal haemoperfusion. One patient in the charcoal group with the greatest rises in β-thromboglobulin (860 hg/ml) and screen filtration pressure (205 mmHg) developed severe hypotension and haemoperfusion was terminated after 1 hour. One patient in the resin group showed rapid consumption of heparin after 2 hours. Measurement of β-thromboglobulin is a sensitive assay of platelet activation during haemoperfusion. Albumin-coated resin haemoperfusion appears to be a more blood-compatible procedure with respect to platelets than charcoal haemoperfusion.