High-volume plasma exchange in patients with acute liver failure: An open randomised controlled trial

Larsen, Fin Stolze; Schmidt, Lars E.; Bernsmeier, Christine; Rasmussen, Allan; Isoniemi, Helena; Patel, Vishal C.; Triantafyllou, Evangelos; Bernal, William; Auzinger, G.; Shawcross, Debbie L.; Eefsen, Martin; Bjerring, Peter Nissen; Clemmesen, J; Höckerstedt, K; Frederiksen, Hans Jørgen; Hansen, Bent Adel; Antoniades, Charalambos; Wendon, Julia

doi:10.1016/j.jhep.2015.08.018

Cited by 547 publications

(475 citation statements)

References 35 publications

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“…PE can improve the liver function by eliminating a wide array of accumulated toxins in patients with liver failure and providing an environment conducive to liver regeneration and can serve as an effective therapy for bridging the failing liver to LT [4,9]. Our previous retrospective study proved that PE improved the short-term survival of HBV-ACLF treated with ETV [5].…”

Section: Discussionmentioning

confidence: 91%

The Strategy of Combining Antiviral Agent, Plasma Exchange and Transarterial Mesenchymal Stem Cell Transfusion in a Patient with Hepatitis B Virus (HBV) Related Acute-on-Chronic Liver Failure

Li¹,

Wu²,

Yang³

et al. 2016

Transl Med

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Acute on chronic liver failure (ACLF) is a newly recognized clinical entity with diverse etiology and an extremely high mortality rate. It may be rapidly fatal due to multi-organ failure. Liver transplantation (LT) is the best strategy for rescuing patients with ACLF. However, LT is not always possible due to donor shortage and/or high operation cost. The search for a strategy to provide temporary liver support and bridge the patients with ACLF to LT remains an important issue. Here, we report a case of hepatitis B virus (HBV) related ACLF patient who was successfully treated by repeated plasma exchange (PE) and umbilical cord-derived mesenchymal stem cell transfusion (UC-MSC) in combination with antiviral therapy with entecavir (ETV).

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Section: Discussionmentioning

confidence: 91%

The Strategy of Combining Antiviral Agent, Plasma Exchange and Transarterial Mesenchymal Stem Cell Transfusion in a Patient with Hepatitis B Virus (HBV) Related Acute-on-Chronic Liver Failure

Li¹,

Wu²,

Yang³

et al. 2016

Transl Med

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“…[26,38] However, the albumin loss during Prometheus-therapy can reach 3 g/L (P = 0.055). [31,39] We observed no significant negative dynamics of serum albumin [oscillations: 32 (30-35) and 30 (26)(27)(28)(29)(30)(31)(32)(33)(34)(35) g/L, P = 0.052, before and after MARS-therapy; 33 (31-34) and 31 (28-36) g/L, P = 0.051, before and after Prometheus-therapy], which is probably due to the adequate routine correction of hypoproteinemia in patients with ALF. [39] Likewise, despite published data on the loss of coagulation factors during Prometheus-therapy, [40] we did not observe clinically significant hemorrhagic complications.…”

Section: Extracorporeal Blood Purification In Intensive Care Patientsmentioning

confidence: 84%

“…[27,28] SPAD therapy uses standard equipment for kidney replacement therapy with a highly porous membrane dialyzers and albumin containing dialysis solutions to remove hydrophobic substances.…”

Section: Extracorporeal Blood Purification In Intensive Care Patientsmentioning

confidence: 99%

Blood purification in intensive care patients with multiple organ dysfunction syndrome and sepsis after cardiac surgery

Yaroustovsky¹,

Abramyan²,

Komardina³

et al. 2017

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How to cite this article: Yaroustovsky M, Abramyan M, Komardina E, Nazarova H. Blood purification in intensive care patients with multiple organ dysfunction syndrome and sepsis after cardiac surgery. Vessel Plus 2017;1:49-60.Extracorporeal blood purification is becoming increasingly important in intensive therapy for multiple organ dysfunction syndrome (MODS) and sepsis, considering all of their pathophysiological aspects. The results of treatment, particularly in children, considering their anatomical and physiological features, are related to the severity and progression of organ failure, the indications that are found, the choice of method, and the timely initiation of blood purification. Multiple organ support therapy is the aim of introducing and applying blood purification today. Various extracorporeal blood purification techniques directly affect the molecular and electrolyte composition of blood and influence all structures of the human body, which can allow us to correct, recover, replace and maintain homeostasis in MODS. The potential of new extracorporeal molecular technologies allows their successful use in severe cardiac and respiratory failure, acute kidney injury and hepatic dysfunction and in complex therapy for severe infections and sepsis and extreme metabolic violations. Adult and pediatric patients after cardiac surgery with cardiopulmonary bypass form a special cohort that often requires the application of various intra-and extracorporeal techniques due to the development of MODS, infections and sepsis in the postoperative period. Key words:Extracorporeal blood purification, acute kidney injury, acute liver failure, extracorporeal membrane oxygenation, sepsis, selective lipopolysaccharideadsorption, critical condition, cardiovascular surgery ABSTRACT Article history:

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“…Therefore, it may be important to restore an appropriate inflammatory response of the host in the initial phase of SIRS and prevent progression to CARS. Plasma exchange (PE), by causing elimination of a wide array of accumulated toxins in patients with liver failure, can facilitate recovery of the failing liver by providing an environment conducive to liver regeneration and can be used as an effective therapy for bridging the failing liver to LT [2,5]. During this procedure, the patient's plasma is removed an exchanged with fresh frozen plasma.…”

mentioning

confidence: 99%

“…Treatment with PE in addition to correction of coagulopathy can potentiate removal of toxic metabolites as well as the poorly identified mediators of multiorgan failure. In a recent prospective, multicenter, randomized controlled trial of 182 patients with acute liver failure, treatment with high-volume PE was shown to modulate the inflammatory cytokine storm, dampen the antiinflammatory responses and ameliorate multiorgan failure, which was associated with improved transplant-free survival [5]. However, there have been no randomized controlled trials of PE for ACLF.…”

mentioning

confidence: 99%

Plasma exchange for acute on chronic liver failure: is there a light at the end of the tunnel?

Maiwall

Moreau

2016

Hepatol Int

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High-volume plasma exchange in patients with acute liver failure: An open randomised controlled trial

Cited by 547 publications

References 35 publications

The Strategy of Combining Antiviral Agent, Plasma Exchange and Transarterial Mesenchymal Stem Cell Transfusion in a Patient with Hepatitis B Virus (HBV) Related Acute-on-Chronic Liver Failure

The Strategy of Combining Antiviral Agent, Plasma Exchange and Transarterial Mesenchymal Stem Cell Transfusion in a Patient with Hepatitis B Virus (HBV) Related Acute-on-Chronic Liver Failure

Blood purification in intensive care patients with multiple organ dysfunction syndrome and sepsis after cardiac surgery

Plasma exchange for acute on chronic liver failure: is there a light at the end of the tunnel?

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