Effects of Charcoal Hemoperfusion with Prostacyclin on the Coagulation-fibrinolysis System and Platelets of Patients with Fulminant Hepatic Failure — Preliminary Observations

Abstract

The coagulation-fibrinolysis system and platelet function were studied in two patients with fulminant hepatic failure undergoing charcoal hemoperfusion with prostacyclin (PGI2) infusion. There was no adverse effect on the purely coagulative side and significant decreases were found only in Factors V and VII. There was a significant increase in platelet count and initially high BTG values decreased to normal. The findings suggest that PGI2 greatly improves the biocompatibility of hemoperfusion devices.

Disorders of Haemostasis

“…Extracorporeal perfusion through activated charcoal columns coated with biocompatible polymers is commonly associated with the formation of platelet aggregates which lead to an increase of filtration pressure, thrombocytopenia, and the production of platelet function defects, which may compound the haemostatic disturbance [92]. Prostacyclin administration may ameliorate some of the hemostatic alterations induced by charcoal haemoperfusion [14].…”