Despite technological advances the mortality of Multiple Organ Failure MOF (or MODS) remains high. Liver is the main excretory organ for protein-bound toxins which accumulate in plasma of patients with hepatic failure. Hydrophobic molecules are present in plasma of patients with several toxic syndromes. Fluorescence is a characteristic of many aromatic compounds. Hydrophobic Fluorescent Molecules (HFM) in plasma have been studied in patients with MOF and hyperbilirubinemia. Heparinized venous plasma from 9 patients with MOF in post-operatory time (after cardiac surgery) was analyzed. All patients presented hyperbilirubinemia. One millilitre of plasma was extracted with 6 ml. of diethyl ether. Fluorescence of the ether fraction was determined with a digital filter fluorometer (excitation 300-400 nm. Emission >400 nm). Results were expressed in Fluorescence Arbitrary Units (A.U.). Control plasma were obtained from patients with chronic cardiac diseases; they had values mean 15 AU± 4,3 A.U. (range 11-21) of hydrophobic fluorescence. The mean Hydrophobic fluorescence of the MOF patients was 218.4 ± 276.3 A.U. (range 37-900). Data were highly significant (P<0.001).
This preliminary study has shown that extremely high values of HFM are present in patients with hepatic failure and MOF. Hydrophobic molecules present a high inherent toxicity due to their insertion in the lipid bilayer of cell membranes and may be a determinant factor for the mortality of patients with MOF. The presence of specific HFM may be evaluated as a marker for prognostic purposes.