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Jens Hartmann

Publications and source records attributed to Jens Hartmann.

5 recordsLinked to original sources

Efficient adsorption of tumor necrosis factor with an in vitro set-up of the microspheres-based detoxification system.

BACKGROUND: The Microsperes-Based Detoxification System (MDS) represents a flexible therapeutic option for various diseases, depending on the specificity of the adsorbents applied. A potential application of the MDS is the supportive therapy of sepsis. METHODS: Microadsorbents for tumor necrosis factor (TNF) were prepared by immobilization of anti-TNF antibodies on cellulose (1-10 microm) and applied in an experimental set-up using a pool of human plasma (1 liter) spiked with TNF (800 pg/ml) and its soluble receptors (1,000 pg/ml each). Removal of TNF was compared using a plasma filter and the albumin-permeable filter Albuflow. RESULTS: Addition of 4 (2) g of adsorbent to the filtrate circuit reduced TNF concentrations in the pool by 80% (64%). Removal rates did not differ significantly for the different filters. TNF adsorption was not influenced by the presence of excess TNF receptors. CONCLUSIONS: Concentrations of mediators can be efficiently modulated with the MDS using small quantities of specific adsorbents.

Adsorption↗

Fluidized bed adsorbent systems for extracorporeal liver support.

Acute liver failure based on acute-on-chronic liver failure (AoCLF) or on acute severe damage of the liver caused by different etiologies includes complex mechanisms resulting in severe disturbances of principle liver functions. In order to compensate the liver's function of detoxification as efficiently as possible, fluidized bed absorbent systems have been designed. In these systems, small particles with specific adsorption properties for toxins related to acute liver failure are applied. A special technology based on adsorbents in suspension has been developed under the guidance of our group and is prepared for clinical application during the coming year. This technology is called microspheres-based detoxification system (MDS) and is based on microadsorbents with a diameter of 1-10 microm which are recirculated in suspension. The safety of the MDS is guaranteed by the use of fluorescently labeled magnetic microparticles, which in case of a membrane-leakage are detected in the blood circuit by an optical system equipped with a magnetic trap. In vitro tests with two kinds of microadsorbents (a combination of a hydrophobic neutral resin and an anion exchange resin) showed excellent efficiency of the system with respect to adsorption capacity as well as to the kinetics of elimination of albumin-bound substances (e.g. unconjugated bilirubin or cholic acid) and of non-protein-bound substances (e.g. phenol). Moreover, using a plasma filter or the Albuflow filter as membrane filters in the blood circuit, the MDS technology offers the possibility to remove inflammatory mediators such as tumor necrosis factor-alpha (TNF) by additional use of specific adsorbents.

Adsorption↗

Intracolonic penetration of the laparoscopic adjustable gastric banding tube.

The laparoscopic adjustable gastric band (LAGB) has become a common, usually successful treatment for morbid obesity. Complications occur in 10-20%, most commonly band slippage and port system problems, especially infection of the port area. A rare complication is penetration of the band into the stomach. We report the penetration of the tube connecting the port system with the gastric band, into the colon 1 year after treatment of a port infection.

Body Mass Index↗

Particle leakage in extracorporeal blood purification systems based on microparticle suspensions.

AIM: The newly developed 'Microspheres based Detoxification System' (MDS) designed for any extracorporeal adsorption therapy uses microparticles as adsorbents characterized by a size of 1-20 microm in diameter which are recirculated in the secondary (filtrate) circuit connected to a hollow fiber filter located in the primary (blood) circuit. In the case of a leakage or rupture in the hollow fiber filter, microspheres can enter patients' blood circuits and cause embolic episodes in different organs with varying degrees of clinical relevance. Aim of this study was to determine the amount of particles infused to a patient during a long-term treatment under different failure conditions of the filter. METHODS: The filters were prepared by cutting single hollow fibers. Fresh-frozen plasma (FFP) and a mixture of glycerol and water were used as a medium together with microparticles potentially used in the MDS. The amounts of particles transferred from the filtrate into the primary circuit were measured. RESULTS: The analysis of particle transfer in the case of a single cut hollow fiber inside the membrane results in particle volumes of up to 26 ml calculated for 10 h. CONCLUSION: Particle leakage in microparticle suspension based detoxification systems can lead to considerable particle transfer to the patient. Therefore, a particle detection unit which is able to detect critical amounts of particles (<1 ml particle volume/treatment) in the extracorporeal blood line is necessary for patient safety.

Extracorporeal Circulation↗