High recovery rate of consciousness by high‐volume filtrate hemodiafiltration for fulminant hepatitis

Fujiwara, Keiichi; Abe, Ryuzo; Yasui, Shin; Yokosuka, Osamu; Kato, Naoya; Oda, Shigeto

doi:10.1111/hepr.13255

Cited by 30 publications

(43 citation statements)

References 22 publications

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“…Also, the number of patients with underlying diseases, such as dyslipidemia, who receive medication has been increasing in recent years because of the overall aging of patients. The trend in therapies for patients with acute liver failure, including artificial liver support and glucocorticoid treatment, 21,22 did not differ between cohorts 1 and 2. The number of patients receiving anticoagulant therapies was higher in cohort 2 than in cohort 1, but the reason for such increase were unclear.…”

Section: Discussionmentioning

confidence: 86%

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Deteriorated outcome of recent patients with acute liver failure and late‐onset hepatic failure caused by infection with hepatitis A virus: A subanalysis of patients seen between 1998 and 2015 and enrolled in nationwide surveys in Japan

Nakazato

Nakayama

Uchida

et al. 2019

Hepatology Research

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Aim A nationwide survey of acute liver failure (ALF) and late‐onset hepatic failure (LOHF) has revealed that the outcomes of recent patients whose diseases were caused by infection with hepatitis A virus (HAV) have worsened, compared with those of previously reported patients. The factors associated with this deterioration were evaluated. Methods A total of 83 patients with HAV infection seen between 1998 and 2015 were enrolled. All the patients had a prothrombin time–international normalized ratio of 1.5 or more and hepatic encephalopathy of grade 2 or more severe. The demographic and clinical features of 45 patients seen prior to 2003 (cohort 1) and 38 patients seen during 2004 and thereafter (cohort 2) were compared. Results Three and four patients in cohort 1 and cohort 2, respectively, received liver transplantations; the survival rates among the remaining patients were 56% for cohort 2 and 79% for cohort 1 (P < 0.05). The mean age (±standard deviation) of the patients was higher in cohort 2 than in cohort 1 (58 ± 11 vs. 48 ± 13 years; P < 0.01). The percentages of patients with underlying metabolic diseases were 22% in cohort 1 and 61% in cohort 2 (P < 0.01). Diabetic mellitus was more common among deceased patients than among rescued patients (29% vs. 8%; P < 0.05) among patients who did not receive liver transplantations, and a multivariate analysis revealed that patient age and disease type were significantly and independently associated with the outcome. Conclusion The outcomes of recent patients with ALF or LOHF caused by HAV infection have recently worsened mainly because of an increase in underlying metabolic diseases as a consequence of aging.

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Section: Discussionmentioning

confidence: 86%

“…The trend in therapies for patients with acute liver failure, including artificial liver support and glucocorticoid treatment, did not differ between cohorts 1 and 2. The number of patients receiving anticoagulant therapies was higher in cohort 2 than in cohort 1, but the reason for such increase were unclear.…”

Section: Discussionmentioning

confidence: 99%

Deteriorated outcome of recent patients with acute liver failure and late‐onset hepatic failure caused by infection with hepatitis A virus: A subanalysis of patients seen between 1998 and 2015 and enrolled in nationwide surveys in Japan

Nakazato

Nakayama

Uchida

et al. 2019

Hepatology Research

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“…Furthermore, focusing on the recent literature in adult ALF we find growing interest about the effective role of TPE [4][5][6][7] and CRRT in CVVHDF mode [8][9][10] to improve HE and blood removal of ammonia, bilirubin, toxic substances, and damage-associated molecular patterns ( Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

Early Hybrid Extracorporeal Therapies in Pediatric Acute Liver Failure of Unknown Etiology

et al. 2020

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We describe a 9-year-old boy with acute liver failure of unknown etiology, unresponsive to standard medical therapy, with increasing hyperammonemia blood level, lactate elevation, a pediatric end liver stage of 20, a hepatic encephalopathy (HE) score of 2, and scheduled for emergent liver transplantation on the waiting list. We admitted him in the pediatric intensive care unit and managed him in the early stages with continuous renal replacement therapy and therapeutic plasma exchange as soon as neurologic impairment started to worsen. He recovered from his HE after 3 days of blood purification and was removed from the transplantation waiting list due to progressive liver function improvement.This case report comply with the guidelines for human studies and the research was conducted ethically in accordance with the World Medical Association Declaration of Helsinki. In the manuscript, parents or guardians have given their written informed consent to publish their case (including publication of images). The study protocol was approved by the institute's committee on human research.

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“…In one case (case 9), plasma exchange was additionally performed, followed by continuous hemodiafiltration for hepatic encephalopathy. Recently, a combination of plasma exchange and continuous hemodiafiltration has been shown to be effective in restoring consciousness in comatose patients with acute liver failure . The patient quickly recovered from hepatic coma after the artificial extracorporeal liver support therapy.…”

Section: Discussionmentioning

confidence: 99%

Outbreak of hepatitis A linked to European outbreaks among men who have sex with men in Osaka, Japan, from March to July 2018

Tanaka

Kishi

Ishihara

et al. 2019

Hepatology Research

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Aim Ongoing hepatitis A outbreaks among men who have sex with men (MSM) have been reported worldwide, mainly in Europe, since 2016. In Japan, there has been an increase in the number of notified hepatitis A cases since January 2018, most of which were suspected to have been transmitted through homosexual contact. In this paper, we describe the current outbreak situation of hepatitis A among MSM. Methods Between March and July 2018, 13 cases of hepatitis A were identified in our hospital. All cases were identified as MSM. Data on clinical and laboratory findings and therapies were collected from medical records. Serum or stool samples were obtained from 13 patients and subjected to sequence analysis. Results Of all patients, 12 reported to have male‐to‐male homosexual contact within 7 weeks prior to symptom onset, and 6 visited sex‐on‐premises venues in the same area. Furthermore, 12 patients were infected with HIV and consequently received antiretroviral therapy with sustained viral suppression. Ten patients received pulsed methylprednisolone therapy. Plasma exchange was additionally carried out in one patient. All patients received inpatient hospital care and were discharged alive. Sequence information, which was available in all cases, showed that the hepatitis A virus strain was identical to the EuroPride strain (RIVM‐HAV16–090). Conclusions Results of sequence analysis suggest that the ongoing hepatitis A outbreak among MSM in Japan is linked to the 2016 European outbreaks. A vaccination program is urgently required for high‐risk populations to control this ongoing outbreak.

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High recovery rate of consciousness by high‐volume filtrate hemodiafiltration for fulminant hepatitis

Cited by 30 publications

References 22 publications

Deteriorated outcome of recent patients with acute liver failure and late‐onset hepatic failure caused by infection with hepatitis A virus: A subanalysis of patients seen between 1998 and 2015 and enrolled in nationwide surveys in Japan

Deteriorated outcome of recent patients with acute liver failure and late‐onset hepatic failure caused by infection with hepatitis A virus: A subanalysis of patients seen between 1998 and 2015 and enrolled in nationwide surveys in Japan

Early Hybrid Extracorporeal Therapies in Pediatric Acute Liver Failure of Unknown Etiology

Outbreak of hepatitis A linked to European outbreaks among men who have sex with men in Osaka, Japan, from March to July 2018

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