Cytokine dialysis: an ex vivo study

ASAIO J. 2002 Nov-Dec;48(6):650-3. doi: 10.1097/00002480-200211000-00013.

Abstract

To test the hypothesis that dialysis using a new large pore membrane would achieve effective cytokine removal, blood from six volunteers was incubated with endotoxin (1 mg) and then circulated through a closed circuit with a polyamide membrane (nominal cut-off: 100 kDa). Hemodialysis was conducted at 1 or 9 L/hr of dialysate flow at the start of circulation and after 2 and 4 hours. The peak dialysate/plasma concentration ratios were 0.92 for interleukin (IL)-1beta, 0.67 for IL-6, 0.94 for IL-8, 0.33 for tumor necrosis factor (TNF)-a, and 0.11 for albumin. The dialysate/plasma ratios for all cytokines and albumin were decreased with increased dialysate flow from 1 to 9 L/hr (p < 0.05). Clearances for IL-1beta, IL-6, and IL-8, however, were significantly improved with increased dialysate flow (p < 0.01). There was no increase in TNF-a clearance (not significant) and a decrease in albumin clearance (p < 0.01). The peak clearance at 9 L/hr was 33 ml/min for IL-1beta, 19 for IL-6, 51 for IL-8, 11 for TNF-alpha, and 1.2 for albumin. No adsorption of cytokines was observed. We conclude that cytokine dialysis is achievable through a membrane with a high cut-off point with negligible albumin loss. These findings support the technical feasibility of this new approach to blood purification in sepsis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Flow Velocity
  • Cytokines / isolation & purification*
  • Diffusion
  • Humans
  • In Vitro Techniques
  • Interleukin-1 / isolation & purification
  • Interleukin-6 / isolation & purification
  • Interleukin-8 / isolation & purification
  • Membranes, Artificial*
  • Renal Dialysis / instrumentation
  • Renal Dialysis / methods*
  • Sepsis / therapy
  • Serum Albumin / metabolism
  • Tumor Necrosis Factor-alpha / isolation & purification

Substances

  • Cytokines
  • Interleukin-1
  • Interleukin-6
  • Interleukin-8
  • Membranes, Artificial
  • Serum Albumin
  • Tumor Necrosis Factor-alpha