A New Procedure for the Removal of Protein Bound Drugs and Toxins

To extend the applicability of dialysis to the removal of albumin bound toxins, a new dialysis procedure was developed. A double sided albumin impregnated high-flux polysulfon dialyzer was used together with a closed loop dialysate compartment with an albumin containing dialysate solution, that was purified on line in a three step process with a charcoal and resin adsorbent, and another dialyzer for a normal dialysis or filtration of the albumin containing dialysate that was then recycled to the albumin impregnated dialyzer. The system effectively removed strongly albumin bound toxins like unconjugated bilirubin or free fatty acids from plasma and blood in vitro and in vivo and therefore could be considered a possible therapeutic means for the treatment of acute liver failure or acute and chronic intoxications with albumin bound toxins, e.g., in drug overdose or chronic renal failure.