Blog Details

Hemoperfusion (HMP)

Hemoperfusion (HMP): Mechanism, Applications, and Clinical Use

Hemoperfusion (HMP) is an extracorporeal blood purification technique that removes toxins, drugs, or inflammatory mediators by adsorption to sorbents (e.g., activated carbon, resins). It is used in emergencies like poisoning, sepsis, or organ failure, though its clinical utility remains debated.

Mechanism

1. Adsorption:
   • Blood flows through a cartridge containing microporous sorbents (e.g., activated carbon, polystyrene resins).
   • Small-to-medium-sized molecules (e.g., toxins, cytokines) bind to the sorbent’s surface, while blood cells pass through unharmed12.
2. Extracorporeal Circuit:
   • Blood is pumped via venovenous access (central vein catheter) or arteriovenous fistula.
   • Anticoagulation (heparin/citrate) prevents clotting in the circuit23.

Applications

1. Toxin Removal:
   • Drug overdoses (e.g., valproic acid, theophylline) or poisoning (e.g., pesticides)14.
   • Hepatic coma: Clears uremic toxins in liver failure15.
2. Sepsis/Inflammation:
   • Adsorption of cytokines (e.g., IL-6, TNF-α) to mitigate organ dysfunction in sepsis36.
3. Combination Therapies:
   • Paired with hemodialysis (HP-HD) or CRRT (HP-CRRT) for dual solute removal23.

Types of Hemoperfusion

Type	Sorbent	Efficiency
Charcoal Hemoperfusion	Activated carbon	Broad-spectrum toxin adsorption15.
Resin Hemoperfusion	Polystyrene (e.g., XAD)	Targets lipid-soluble drugs (e.g., barbiturates)12.
Plasmafiltration-Adsorption	Sorbent beads	Plasma is separated, treated, and reinfused23.

Clinical Considerations

1. Indications:
   • Life-threatening poisoning (e.g., NSAIDs, lithium)14.
   • Sepsis: Experimental use to reduce cytokine storms36.
2. Limitations:
   • Low specificity: Removes both toxins and beneficial molecules (e.g., clotting factors)13.
   • Complications: Thrombocytopenia, hypoglycemia, bleeding risk13.
3. Evidence:
   • Mixed outcomes: Limited efficacy in sepsis trials; reserved for refractory cases36.

Conclusion

Hemoperfusion is a niche therapy for toxin removal or experimental use in sepsis. While technically feasible, its clinical impact is often marginal compared to dialysis or supportive care.

Consult with Our Team of Experts Now!
At DrStemCellsThailand (DRSCT)‘s Anti-Aging and Regenerative Medicine Center of Thailand, we emphasize comprehensive evaluations and personalized treatment plans of Cellular Therapy and Stem Cells for managing various health conditions. If you have questions about Hemoperfusion (HMP) or would like more information on our services, consult with our experts today!

Consult with Our Team of Experts Now!

References

1. Wikipedia: Hemoperfusion
2. PMC: Hemoperfusion Technical Aspects
3. PMC: Hemoperfusion in ICU
4. CMS: Hemoperfusion Coverage
5. Veterinary Practice News: Hemoperfusion
6. Acta Med Indones: Hemoperfusion in ARDS