Dialyzers Outperform Activated Charcoal Filters for Extracorporeal Cisplatin Removal in an Isolated Perfused Porcine Liver Model.

INTRODUCTION

Percutaneous isolated hepatic perfusion enables regional delivery of high-dose chemotherapy while limiting systemic exposure through extracorporeal drug removal. In current clinical practice, this is achieved by the use of activated charcoal-based filtration systems, which are limited by finite adsorption capacity and non-selective binding. Hemodialysis filters may provide a membrane-based alternative for extracorporeal drug elimination. This study compared the efficacy of both systems for cisplatin removal.

METHODS

An isolated perfused porcine liver model was used. Livers were randomized into charcoal filtration, hemodialysis filtration, or control groups (n=5 per group). Cisplatin was administered into the hepatic circulation, and drug removal was performed according to group allocation. Cisplatin concentrations, liver injury markers, bile production, and blood cell counts were assessed.

RESULTS

Hemodialysis filters achieved significantly greater cisplatin clearance compared with activated charcoal filters, with sustained differences over time. Liver injury markers and bile production did not differ between groups. Blood cell counts revealed no relevant treatment effects.

CONCLUSION

Hemodialysis filters improve cisplatin removal without affecting liver injury markers or blood cell counts in this experimental model.