Development of a Machine for Extracorporeal Removal of Lipophilic and Hydrophilic Toxins in Liver Failure

Intoxication is an important clinical sign and a major cause of death in severe liver failure. Safe and effective long-term removal of toxins is an aim which up to the present has not been solved satisfactorily. While hydrophilic toxins can easily and safely be removed by hemodialysis, lipophilic toxins cannot be removed without danger to the patient. The most efficient method to remove lipophilic toxins was hemoperfusion over charcoal or other adsorbents. However, this method is not safe [1] and therefore cannot be repeatedly applied. Its mode of action is unspecific. Not only toxins are removed from the blood but also many important substances like hormones and growth factors. With the newly developed lipophilic hollow fiber method, removal of lipophilic toxins from blood is now effectively possible without depletion of hormones and without immunological hazards [2, 3, 6, 8]. To apply this method alone would, however, leave hydrophilic toxins and their precursors, the amino acids, in extremely increased amounts in the diseased patient. Therefore, a combined removal of lipophilic and hydrophilic toxins and their precursors would be an optimal detoxification in patients with liver disease.