ARTIFICIAL ORGANS STRATHCLYDE BIOENGINEERING SEMINARS ARTIFICIAL ORGANS Proceedings of a seminar on the clinical applications of membrane oxygenators and sorbent-based systems in kidney and liver failure and drug overdose, held at the University of Strathclyde, Glasgow, in August, 1976 Edited by R. M. KENEDI, J. M. COURTNEY, J.D. S. GAYLOR and T. GILCHRIST Editorial Associate SUSAN M. GERARD Bioengineering Unit Wolfson Centre University of Strathclyde M ©Bioengineering Unit, University of Strathclyde 1977 Softcover reprint ofthe hardcover 1st edition 1977 978-0-333-22313-0 All rights reserved. No part of this publication may be reproduced or transmitted, in any form or by any means, without permission First published 1977 by THE MACMILLAN PRESS LTD London and Basingstoke Associated companies in New York Dublin Melbourne Johannesburg and Madras ISBN 978-1-349-03460-4 ISBN 978-1-349-03458-1 (eBook) DOI 10.1007/978-1-349-03458-1 This book is sold subject to the standard conditions of the Net Book Agreement PREFACE The Strathclyde Bioengineering Seminars are held annually and explore in depth a clinically significant problem area within the research activities of the University of Strathclyde's Bioengineering Unit. The series, which is a successor to successful broad-spectrum symposia held in 1964 and 1972, opened in August 1975 with consideration of the biomechanics of tissue viability and its clinical applications. The proceedings of this first seminar have been published by The Macmillan Press under the title of Bed Sore Biomechanics in July, 1976. This present seminar, the second in the series, was held in August, 1976 and considered research, development and clinical applications in the areas of membrane oxygenation and sorbent-based systems. The therapeutic role of the latter was ex plored in kidney and liver failure and drug overdose. There were two hundred and forty-nine participants from Belgium, Canada, England, France, W. Germany, Italy, Israel, the Netherlands, Norway, Scotland, Spain, Sweden and the U.S.A. The details of the Scientific, Technical and Working Group sessions are given in the Contents List. There was also an Exhibition of Related Medical Engineering Equipment in which 20 firms and organisations participated (see page xxiii). All the papers presented, together with additional contributions and the dis cussions are printed complete in this volume, grouped in the six sessions shown in the Contents List. The organisers acknowledge with gratitude their sense of indebtedness to the City of Glasgow District Council for the very enjoyable civic reception given by them for Seminar participants and guests. The first of the newly instituted Adam Thomson Lectures was delivered at this reception by Professor Robert E. Sparks of Washington University, St Louis, USA. In these difficult economic times the continued support of the Seminar pro gramme by the Greater Glasgow Area Board is particularly appreciated. Additionally the organisers are very pleased to acknowledge the contributions of AB Cambro; Becton, Dickinson Ltd.; Extracorporeal; I.C.I.; Norit-Clydesdale Co. Ltd.; Organon Teknika Ltd.; Sandev Ltd.; Sandoz Products Ltd., Medical Equipment Division; and Travenol Laboratories Ltd., towards travelling expenses of invited lecturers. As in previous symposia, banking and travel-agent facilities were made available to participants by courtesy of the Bank of Scotland and Nairn Travel Co. Ltd. and Co. vi PREFACE All the work connected with the seminar was carried out by the staff of the Bioengineering Unit with the unstinted co -operation of the University Adminis tration. The organisers have pleasure in offering for the second year running, and if possible with increased warmth, their best thanks to all concerned. Glasgow, 19 76 R. M. Kenedi SEMINAR ORGANISING COMMITTEE AND SECRETARIAT Jane Bowen Thomas Gilchrist James M. Courtney Robert G. Hood Rita F. Cuthbert Robert M. Kenedi Mary Dickinson Flora Kennedy Ronald Donovan Ann Lawson lain A. Fairweather Roshan Maini John D. S. Gaylor Ann McNair Susan M. Gerard G. Barry Park lain Gibson Elizabeth M. Smith Rosemary Wilkinson SESSION REPORTERS Hector M. Baillie David McClure Anne E. Clarke Jean McKinnon Terence Hanson David F. Radcliffe Thien V. How Peter J. Sharrock Wilf B. Townsend vii LIST OF PARTICIPANTS AND AUTHOR INDEX (a: participating author, a*: nonattending author, c: chairman and chairman-associate) a (pages 351, ABO UNA, George M., M.D., F .R.C.S., Associate Professor of 363) Surgery, Division of Surgery, Health Science Centre, University of Calgary, 2920 24th Avenue, N.W. Calgary, Alberta, Canada, T2NIN4 a* (pages 351, ALEXANDER, F., F.R.C.P.(C.), Division of Surgery, Health 363) Science Centre, University of Calgary, 2920 24th Avenue, N.W. Calgary, Alberta, Canada, T2N 1N 4 ARUNDEL, Philip A., B.Sc.(Eng.), Ph.D., Biomaterials Group, ICI Corporate Laboratory, The Heath, Runcorn, Cheshire, WA7 4QE, UK a (page 395) BAILLIE, Hector M., B.Sc., University of Strathclyde, Bioengineer ing Unit, Wolfson Centre, 106 Rottenrow, Glasgow, G4 ONW, UK c (page 37) BAIN, W. H., M.D., F.R.C.S.(Ed.), F.R.C.S.(Glas.), Consultant Cardiac Surgeon, Department of Cardio-thoracic Surgery, Royal Infirmary, Castle Street, Glasgow, G4 OSF, UK BANDEL, Werner, Ph.D., Plant Manager, Enka Glanzstoff AG, Werk Wuppertal-Barmen, Oder Strasse 28, D-5600 Wuppertal2, West Germany a (page 158) BANTJES, Adriaan, D.Sc., Professor and Head, Biomaterials Technology Section, Department of Chemical Technology, Twente University of Technology, Enschede, The Netherlands a* (pages 351, BARABAS, A. Z., Ph.D., Division of Surgery, Health Science 363) Centre, University of Calgary, 2920 24th Avenue, N.W. Calgary, Alberta, Canada, T2N 1N4 BELLHOUSE, Brian J., M.A., D.Phil., Department of Engineering Science, University of Oxford, Parks Road, Oxford, OX1 3PJ, UK a* (page 61) BELLOWS, Randall F., Vice President International, Cobe Laboratories Inc., 73 Chee Reine Astrid, 1420 Braine-1 Alleud, Brussels, Belgium a* (page 413) BEN-ARIE, D., Department of Chemical Engineering, Technion Israel Institute of Technology, Haifa, Israel a* (page 291) BETTER, 0. S., School of Medicine and Department of Chemical Engineering, Technion Israel Institute of Technology, Haifa, Israel viii UST OF PARTICIPANTS AND AUTHOR INDEX ix BETTLES, Reginald, Manager, Kimal Scientific Products Ltd, Kimal House, Uxbridge Road, Hillingdon Heath, Middlesex, UB10 OPW, UK a* (page 333) BEYER, M. M., Department of Medicine, State University of New York, Downstate Medical Centre, 450 Clarkson Avenue, Brooklyn, NY 11203, USA a* (page 311) BIAGINI, M., Clinical Physiology Centre of the National Research Council (CNR), Ospedali Riuniti di Reggio Calabria, Italy a* (page 248) BIREK, A., Renal Unit, Victoria Hospital, London, Ontario, N6A 4G5, Canada a (page 89) BIRNBAUM, Dietrich, M.D., Surgical Department, Klinikum Charlottenburg, Freie Universitat Berlin, Spandauer Damm 130, D-1000 Berlin 19, West Germany BJQ)RNSON, Jan, M.B. Ch.B., M.R.C.P.(Oslo), Medical Department VII, Ulleval Hospital, Oslo 1, Norway BLACK, Jack, M.D., Vice-President, Experimental Therapeutics, Warner-Lambert Research Institute, 170 Tabor Road, Morris Plains, New Jersey 07950, USA a (page 319) BLACK, Martin M., M.Sc., Ph.D., F.Inst.P., C.Eng., M.R.Ae.S., Professor and Head of Department of Medical Physics, Academic Division of Medicine, University of Sheffield, Western Bank, Sheffield, S10 2TN, UK BODDY, Keith, B.Sc., M.Sc., Ph.D., D.Sc., F.Inst.P., Head of Medical Physics and Nuclear Medicine Unit, Scottish Universities Research and Reactor Centre, East Kilbride, Glasgow, G75 OQU, UK BOON, John, Sales Representative, Sandoz Products Ltd, Medical Equipment Division, 42 Somers Road, Rugby, UK BOWEN, Jane, University of Strathclyde, Bioengineering Unit, Wolfson Centre, 106 Rottenrow, Glasgow, G4 ONW, UK a* (pages 351, BOYD, N., Ph.D., Division of Surgery, Health Science Centre, 363) University of Calgary, 2920 24th Avenue, N.W. Calgary, Alberta, Canada, T2N 1N4 a (page 263) BRASH, John L., B.Sc., Ph.D., Associate Professor, Department of Chemical Engineering, McMaster University, Hamilton, Ontario, Canada, L85 4L7 a* (page 413) BRANDES, J. M., Department of Chemical Engineering, Technion Israel Institute of Technology, Haifa, Israel a (page 388) BRUNNER, Gorig, Priv. Doz. Dr. Med., Medizinische Universitats klinik, 34 Gottingen, 1 Humboldtallee, West Germany a* (page 89) BUCHERL, E. S., Surgical Department Klinikum Charlottenburg, Freie Universitat Berlin, Spandauer Damm 130, D-1 000 Berlin 19, West Germany CAPON, Andrew, B.Sc., Ph.D., C.D.E. Porton Down, Nr. Salisbury, Wiltshire, SP4 OJQ, UK X LIST OF PARTICIPANTS AND AUTHOR INDEX a* (pages 372, CASTINO, F., Ph.D., Department of Artificial Organs, Cleveland 378) Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44106, USA CHAMULEAU, Robert A. F. M., M.D., Binnengasthuis, University of Amsterdam, Poliklinick Interne, Grimburgwal10, Amsterdam, The Netherlands c, a (pages 121, CHANG, Thomas M.S., M.D., Ph.D., F.R.C.P.(C.), Professor of 164, 233) Medicine and Physiology, Director Artificial Organs Research Unit, Rm 1004, Artificial Organs Research Unit, Mcintyre Medical Sciences Building, McGill University, 3655 Drummond Street, Montreal, PQ, Canada CHARLESWORTH, Elizabeth A., B.Sc., M.B., B.S., L.R.C.P., M.R.C.S., Medical Advisor, Clinical Research Department, ICI Pharmaceuticals Division, Alderley Park, Macclesfield, Cheshire, SK104TG, UK CLARKE, Anne E., B.Sc., University of Strathclyde, Bioengineering Unit, Wolfson Centre, 106 Rottenrow, Glasgow, G4 ONW, UK COLLINS, Eric, Sales Manager, AB Gambro, 150A Eltham Hill, London, SE9 SEA, UK a* (page 425) COLON, A., M.D., Departments of Medicine and Pediatrics, Georgetown University Hospital, Washington, DC 20007, USA a* (page 248) COOPER, J., Renal Unit, Victoria Hospital, London, Ontario, N6A 4G5, Canada a (page 133) COURTNEY, James M., B.Sc., Ph.D., A.R.C.S.T., C.Chem., M.R.I.C., A.P.R.I., University of Strathclyde, Bioengineering Unit, Wolfson Centre, 106 Rottenrow, Glasgow, G4 ONW, UK a* (page 178) CROME, P., M.B., M.R.C.P., D.Obst., R.C.O.G., Registrar, National Poisons Information Service, New Cross Hospital. Poisons Unit, Avonley Road, London, SE14 SER, UK CROSS, D. E., M.Sc., Portex Ltd, Hythe, Kent, CT21 6JL, UK CUTHBERT, Rita, University of Strathclyde, Bioengineering Unit, Wolfson Centre, 106 Rottenrow, Glasgow, G4 ONW, UK a* (page 105) DARRAGON, T., Service de Reanimation Medicale, Hopital Ambroise Pare, Boulogne, France DAVIES, Edgar J., B.Sc. (Chem.Eng.), Sales Executive, Sutcliffe Speakman and Co, Guest Street, Leigh, Lancashire, UK DEBENHAM, Michael, Group Product Manager, Surgikos Division, Johnson and Johnson, 260 Bath Road, Slough, Berks., SLl 4EA, UK c, a (pages 121, DENTI, Ennio, Ph.D., Head of Artificial Organs Division, 233, 311) c/o Sorin Biomedica, 13040 Saluggia, Italy DICKINSON, Mary, University of Strathclyde, Bioengineering Unit, Wolfson Centre, 106 Rottenrow, Glasgow, G4 ONW, UK VANDER DOES, Leendert, D.Phil., Polymer Division, Department of Chemical Technology, Twente University of Technology, Enschede, The Netherlands