Extracorporeal Support of Liver Function (II Part)

Santoro, Antonio; Mancini, Elena; Buttiglieri, Stefano; Krause, Alfred; Yakubovich, Michaela; Tetta, Ciro

doi:10.1177/039139880402700304

Cited by 11 publications

(10 citation statements)

References 34 publications

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“…Extracorporeal blood purification treatments for hepatic toxin removal have been introduced to support the liver detoxification function, bridging the patient either to orthotopic liver transplantation or to functional recovery [3][4][5][6]. Acute kidney injury may complicate the clinical condition, and dialysis techniques, able to remove only small water-soluble compounds, are not effective for liver support [7], since liver toxins are mainly proteinbound [3,6].…”

Section: Introductionmentioning

confidence: 99%

“…Acute kidney injury may complicate the clinical condition, and dialysis techniques, able to remove only small water-soluble compounds, are not effective for liver support [7], since liver toxins are mainly proteinbound [3,6].…”

Section: Introductionmentioning

confidence: 99%

“…Extracorporeal therapies, mainly based on albumin and/or plasma-adsorption [3,6,[8][9][10] have been developed for this purpose, presenting some aspects (technical complexity, cost) that may affect their use in clinical practice [3,[8][9][10]. High-volume plasma-exchange has recently been introduced as well, some results only reducing innate immune activation in acute LF [11].…”

Section: Introductionmentioning

confidence: 99%

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Removal of Bilirubin with a New Adsorbent System: In Vitro Kinetics

Gemelli

Cuoghi

Magnani³

et al. 2018

Blood Purif

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Background/Aims: Many potentially toxic molecules accumulate in the blood during hepatic dysfunction. In clinical practice, it is very difficult to remove bilirubin, the most widely studied toxin, and particularly the unconjugated form, strongly albumin-bound. The aim of this in vitro study was to assess irreversible bilirubin adsorption as a protein-bound compound marker, using Cytosorb® (Cytosorbents Corp.), a new hemoadsorption device designed to remove cytokines. Methods: We performed 4 in vitro experiments, dynamic and static, with different albumin-bilirubin solutions. Results: All experiments showed the resin’s ability to break the albumin-bilirubin complex (Experiment 1, 2), leading to efficient bilirubin removal for 24 h (Removal Rate: 90% Experiment 3) with minimal albumin loss. No sign of bilirubin release from the charged resin was detected (Experiment 4). Conclusion: Cytosorb® seems a promising artificial liver support, thanks to its ability to adsorb bilirubin and its proven ability to modulate the cytokines involved in hepatic dysfunction.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Removal of Bilirubin with a New Adsorbent System: In Vitro Kinetics

Gemelli

Cuoghi

Magnani³

et al. 2018

Blood Purif

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“…Artificial Liver Support System (ALSS) has been used as a promising liver assistance system for years and has efficiently decreases the mortality of patients with severe hepatitis in the early and middle stages [11][12], as well as liver cirrhosis and liver failure [13][14]. For patients who developed massive necrosis of hepatocytes and lost ability of liver regeneration, several times of ALSS and sequential timely LT were needed [15].…”

Section: Discussionmentioning

confidence: 99%

Hepatitis E virus infection results in acute graft failure after liver transplantation: a case report

Liu

Shen

Wang

et al. 2014

J Infect Dev Ctries

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Hepatitis E virus (HEV) infection in most individuals is known as a self-limiting, acute, icteric hepatitis, but evidence shows HEV is responsible for choric hepatitis and rapid progressed liver cirrhosis in immuno-compromised patients. We present the case of a patient whose diagnosis of acute graft failure was due to a HEV infection 7 years after his first liver transplantation because of Wilson's disease. The process showed severe jaundice with fatigue, poor appetite and continually rising serum aminopherase. The blood serum was found positive for the anti-HEV IgG antibody but negative for anti-HEV IgM or other infections. Cholangiole cholestasis was detected in graft biopsy. Triple hepato-protective drugs (Transmetil, Polyene Phosphatidylcholine, and Compound Ammonium Glycyrrhetate S) alongside five times Artificial Liver Support System (ALSS) did not improve the patient's condition, but the total bilirubin level rose to more than 900umol/L. So re-transplantation was performed. Blood testing shows normal liver enzymes and bilirubin with persisting anti-HEV IgG antibody positive at the 3-month follow-up.

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“…They are mainly used temporarily as a bridge to liver transplantation or until the liver regenerates and to date, have no impact on survival. [78] It is thought that toxins contribute to the clinical picture of fulminant hepatic failure. These mechanical liver-support devices filter toxins.…”

Section: Discussionmentioning

confidence: 99%

Fulminant hepatic failure following marijuana drug abuse: Molecular adsorbent recirculation system therapy

et al. 2013

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Marijuana is used for psychoactive and recreational purpose. We report a case of fulminant hepatic failure following marijuana drug abuse who recovered following artificial support systems for acute liver failure. There is no published literature of management of marijuana intoxication with molecular adsorbent recirculation system (MARS). MARS is effective and safe in patients with fulminant hepatic failure following marijuana intoxication.

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Extracorporeal Support of Liver Function (II Part)

Cited by 11 publications

References 34 publications

Removal of Bilirubin with a New Adsorbent System: In Vitro Kinetics

Removal of Bilirubin with a New Adsorbent System: In Vitro Kinetics

Hepatitis E virus infection results in acute graft failure after liver transplantation: a case report

Fulminant hepatic failure following marijuana drug abuse: Molecular adsorbent recirculation system therapy

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