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Biomedical subjects

M J Lysaght

Publications and source records attributed to M J Lysaght.

At least 37 records · Page 2Linked to original sources

Analytical comparison of single-pass and dead-end operation in cascade filtration plasmapheresis.

Derived mathematical models are employed to compare cascade filtration plasmapheresis in the dead-end and single-pass formats. The high filtration fraction and low sieving coefficients associated with single-pass cascade filtration are shown to require treatment of the retentate concentration profile in an integrated rather than a length-averaged fashion. The models are best applied to specific simulations, but in general predict that (a) for a given membrane, the dead-end format will yield a higher albumin recovery but a lower macroglobulin rejection than single pass; (b) the single-pass format is more suited to loose membranes and the dead-end to tight membranes; and (c) in the single-pass but not the dead-end format, solute recovery is conveniently independent of the quantity filtered. Agreement between predicted and measured performance is good, although a larger data base would be required for complete validation of the models.

Models, Theoretical↗

Comparative evaluation of filters used in membrane plasmapheresis.

Protocols were developed for in vivo and in vitro characterization of the mass transfer performance of filters intended for use in membrane plasmapheresis. The protocols were applied to all presently available filters and also to secondary filters used in cascade filtration. Virtually no distinction was found in filtration rate or sieving coefficient of the ten plasma filters tested and all, except for one early model now considered obsolete, are clinically equivalent. In contrast, filters for cascade filtration varied widely in performance and still require further development for optimal use.

Filtration↗

A comparison of centrifugal and membrane-based apheresis formats.

Membrane and centrifugal apheresis operate on different physical principles but are both capable of efficiently fractionating plasma proteins from whole blood. For therapeutic purposes, both formats yield about the same protein clearance per liter of solute exchanged and neither is significantly more rapid than the other. Only continuous centrifugation can be used to pherese cellular elements and only membrane filter can be deployed in 'spontaneous' circuits. Hardware for continuous centrifugation is more expensive and disposables less expensive than for the membrane methods; the 'crossover' occurs at 200 treatments. To date, only the centrifugal method is employed for donor apheresis; this may change in the future as membranes can yield a truly platelet-free product and appear to offer a much more rapid collection cycle.

Blood Donors↗

Hemodynamics in hemofiltration.

To study the established but not well understood phenomenon of improved intratreatment vascular stability during hemofiltration the same 10 stable hemodialysis patients were investigated during one hemodialysis and one hemofiltration treatment. Both treatments were matched in regard to linear fluid withdrawal (3 kg/240 minutes), small molecule removal rate (Curea 120 ml/min). Sodium (140 meq/l) and acetate (35 meq/l) concentration in dialysate and replacement fluid were identical. Outcome measures included mean arterial blood pressure, total peripheral vascular resistance by thermodilution, plasma noradrenaline concentration as index of sympathetic activity and sodium loss per treatment. Blood pressure was maintained during hemofiltration, while total peripheral vascular resistance and plasma noradrenaline concentrations increased. During hemodialysis mean arterial blood pressure fell significantly, total peripheral resistance and plasma noradrenaline concentrations remained unchanged. During both treatment modalities sodium loss was comparable. It is concluded, that the improved hemodynamic stability during hemofiltration is due to a maintained physiologic response to ultrafiltration, which is impaired during hemodialysis. Vascular stability during hemofiltration is not due to sodium retention relative to hemodialysis.

Adult↗

Artificial pancreas using living beta cells:. effects on glucose homeostasis in diabetic rats.

An artificial pancreas consisting of beta cells cultured on synthetic semipermeable hollow fibers was tested in rats with alloxan-induced diabetes. When implanted ex vivo as arteriovenous shunts in the circulatory system these devices lowered concentrations of plasma glucose from 533 to between 110 and 130 milligrams per 100 milliliters, increased concentrations of plasma insulin, and restored intravenous glucose tolerance tests essentially to normal.

Animals↗