臨牀透析 Vol.21 No.2(8)


特集名 血液浄化療法の新しいmodality
題名 濾過再生型血液濾過 (人工尿細管型)
発刊年月 2005年 02月
著者 斎藤 明 東海大学総合医学研究所分子病態学部門II
【 要旨 】 患者血液から7 ml / minの持続血液濾過を行い,濾過液は近位尿細管上皮細胞を中空糸モジュール内面に生着させたバイオ人工尿細管デバイス内を通過させ,中空糸外側を流れる患者血液へ能動輸送された濾過液 (4 ml / min) を患者血液とともに静脈に戻すシステムを確立する.持続濾過器は膜面積0.2-0.3m2のものを用い,人工尿細管デバイスにはポリスルホンまたはポリイミド膜 (膜面積0.8-1.0m2) の中空糸内面にヒト近位尿細管上皮細胞をコンフルエントな単層を形成させたものを用いる.人工尿細管デバイスが1カ月機能するには,遺伝子導入による細胞の不死化・安定化が必要である.
Theme New Modalities in Blood Purification Therapies
Title Hemofiltration with artificial tubules -- regeneration of filtrate
Author Akira Saito Department of Molecular Medicine, Institute of Medical Science, Tokai University
[ Summary ] An ultrafiltrate obtained at flow rates of 7 ml / min by continuous hemofiltration was introduced into a hollow fiber module, in which proximal tubular epithelial cells were grown on the inner surfaces. The filtrate water was actively transported to the patient's blood across the cell-attached hollow fiber membranes at the rate of 4 ml / min, 3 ml / min of the filtrate was discarded since the same amount would be replaced by drinking and meals. A bioartificial tubule device with a membrane area of 0.8 m2 can transport 6 l of water, sodium and glucose solution over 24 hours.
A continuous hemofilter with a membrane area of 0.2-0.3 m2, which can receive filtrate from a patient at the rate of 7 ml / min, may be kept in a vest pocket. A double headed Watson-Marlow tube pump (WM-313), put in a lumber pouch or a back pack, can control the blood flow rate of 100 ml / min and a filtration rate of 7 ml / min at the same time.
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