Feasibility of hemoperfusion using extracorporeal therapy in the horse.
Authors: Hobbs Kallie J, Le Sueur Andre N V, Burke Megan J, Cooper Bethanie L, Sheats M Katie, Ueda Yu
Journal: Frontiers in veterinary science
Summary
# Editorial Summary: Hemoperfusion in Equine Medicine Researchers from North Carolina State University evaluated whether polymer-based hemoperfusion—an extracorporeal blood purification technique already used in human critical care—could be safely implemented in horses, with the ultimate goal of reducing excessive inflammatory cytokine activity in septic or systemically inflamed equines. Three healthy adult horses underwent 240-minute hemoperfusion sessions via temporary haemodialysis catheters whilst maintained on unfractionated heparin anticoagulation, with the team iteratively refining their protocol and monitoring for clinical, biochemical, and immunological changes. Although one horse showed the hoped-for reduction in plasma cytokine concentrations, the group overall demonstrated no significant cytokine suppression from the therapy itself; notably, platelet counts decreased and serum albumin concentrations fell during treatment—findings requiring careful consideration when applying this technology to compromised patients. These results establish hemoperfusion as a technically feasible extracorporeal modality in adult horses, opening the door to targeted investigation of its clinical efficacy in sepsis, toxin elimination, and immune-mediated disease, though practitioners should anticipate that further protocol refinement and large-scale efficacy trials remain necessary before clinical adoption.
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Practical Takeaways
- •Hemoperfusion is a technically feasible extracorporeal therapy option in horses, but remains experimental—monitor platelet counts and albumin closely if considering this therapy
- •This early work does not yet demonstrate clinical benefit in diseased horses; its role in treating sepsis, toxicity, or immune conditions remains to be determined
- •Expect protocol refinement as this therapy matures; work with specialists experienced in extracorporeal therapies if considering hemoperfusion for clinical cases
Key Findings
- •Polymer-based hemoperfusion was successfully implemented in 3 healthy adult horses with 240-minute sessions without major adverse effects
- •Hemoperfusion therapy was associated with decreased platelet counts and serum albumin concentration
- •No significant change in plasma cytokine concentrations occurred with hemoperfusion in most horses, though one horse showed decreased cytokine levels
- •Protocol development through iterative modification in healthy horses has established feasibility for future clinical application in disease states