Plasma versus whole blood perfusion in a bioartificial liver assist device
Plasma versus whole blood perfusion in a bioartificial liver assist device
复制标题
DOI：
10.1097/00002480-200205000-00005
复制
发表时间：
2002-05-01
期刊：
影响因子：
4.2
通讯作者：
Miller, R
中科院分区：
文献类型：
--
作者：
Patzer, JF;Campbell, B;Miller, R
通过将全血灌注作为一个二室系统的动态模型，探讨了使用全血或血浆灌注含肝细胞的生物人工肝生物反应器（其中肝细胞通过膜或其他物理屏障与灌注液流分离）对患者血液浓度变化率的影响（患者组织和血液隔室）和血浆灌注作为三隔室系统（患者组织和血液隔室，以及血浆储存器）。全血灌注模型由三个无量纲参数描述：达姆科勒数Da，其表示生物反应器的转化速率与灌注速率的比率; kappa，其表示组织和血液隔室之间的内部再平衡速率与灌注速率的比率;以及V-br，组织/血液体积比。血浆灌注模型具有三个额外的无量纲参数：f，血浆分离器中从血液中抽取的血浆分数; a，生物反应器中血浆灌注速率与血液抽取速率的比率;以及V-br，血液/血浆储库体积比。在参数的生理范围内，全血灌注和血浆灌注系统中的血液浓度降低速率对达姆科勒数敏感，达姆科勒数高达Da，类似于2。这两种系统对K的变化都不敏感，并且血浆灌注系统对a的敏感性很小。鉴于生物反应器的活性相当，在相同的灌注时间，全血灌注将实现更大的血药浓度降低率和更低的终点血药浓度。这有两个物理原因。第一个是与全血灌注系统相比，血浆灌注系统仅处理血液的一部分f。第二个原因是，尽管血液灌注系统受到整体生物反应器性能的限制，但血浆灌注系统的传质受限于血液浓度稀释进入血浆储存器的速率，而不是受到整体生物反应器性能的限制。
The ramifications of using whole blood or plasma for perfusion of an hepatocyte containing bioartificial liver bioreactor in which the hepatocytes are separated by a membrane or other physical barrier from the perfusate stream on the rate of change of patient blood concentrations are explored through dynamic modeling of whole blood perfusion as a two compartment system (patient tissue and blood compartments), and plasma perfusion as a three compartment system (patient tissue and blood compartments, and a plasma reservoir). The whole blood perfusion model is described by three dimensionless parameters: the Damkohler number, Da, which represents the ratio of the rate of conversion by the bioreactor to the rate of perfusion; kappa, which represents the ratio of the rate of internal reequilibration between the tissue and blood compartments and the rate of perfusion; and V-br the tissue/blood volume ratio. The plasma perfusion model has three additional dimensionless parameters: f, the fraction of plasma withdrawn from the blood in a plasma separator; a, the ratio of the plasma perfusion rate in the bioreactor to the blood draw rate; and V-br, the blood/plasma reservoir volume ratio. Within the physiologic range of parameters, the rate of reduction in blood concentration in both the whole blood-perfused and plasma-perfused systems are sensitive to Damkohler number up to Da similar to 2. Neither system is sensitive to variations in K, and the plasma perfusion system has little sensitivity to a. Given bioreactors of equivalent activity, a greater rate of blood concentration reduction and lower endpoint blood concentration at equivalent perfusion times will be achieved with whole blood perfusion. There are two physical reasons for this. The first is that the plasma perfused system is only processing a fraction, f, of the blood compared with the whole blood perfusion system. The second reason is that, although the blood-perfused system is limited by overall bioreactor performance, the plasma-perfused system is mass transfer limited to the rate of blood concentration dilution into the plasma reservoir rather than limited by the overall bioreactor performance.