Hemoperfusion refers to the direct perfusion of blood. In general, it refers to the perfusion of whole blood over a sorbent or reactor and therefore is different in this respect from hemodialysis (Fig. 5). In principle, the sorbent or reactor may consist of a wide variety of agents such as activated charcoal, nonionic or ionic resins, immunosorbents, enzymes, cells, or tissue. The purpose of biologically active agents may be to remove specific toxins from the blood or to carry out specific biochemical reactions. For practical reasons, such as biocompatibility concerns, hemoperfusion has been limited to the use of a small number of sorbents such as activated charcoal or resins in the treatment of drug intoxication or hepatic support.

The sorption of solute from the blood is based primarily upon its chemical affinity for the sorbents and less on its molecular size. The surface area for sorption may be as high as hundreds of square meters per gram of sorbent.

The use of hemoperfusion is limited primarily by biocom patibility concerns, including particulate release from the sorbent or reactor system. Sorbent and reactor systems are also applied to plasma perfusion (see the next section).

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