Results of Treatment of Acute Liver Failure Patients With Use of the Prometheus FPSA System

Grodzicki, Mariusz; Kotulski, Marcin; Leonowicz, D.; Zieniewicz, Krzysztof; Krawczyk, Marek

doi:10.1016/j.transproceed.2009.08.024

Cited by 40 publications

(22 citation statements)

References 8 publications

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“…Many studies have demonstrated their consistent detoxification ability and amelioration of hepatic encephalopathy during ALF [9][10][11][12][13], while several large randomised trials in patients with ALF [14] and acute-on-chronic liver failure (ACLF) [15,16] have shown disappointing results for increasing survival rate.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of coupled low-volume plasma exchange with plasma filtration adsorption in treating pigs with acute liver failure: A randomised study

Zhou¹,

Li²,

Zhang³

et al. 2015

Journal of Hepatology

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Section: Introductionmentioning

confidence: 99%

Efficacy of coupled low-volume plasma exchange with plasma filtration adsorption in treating pigs with acute liver failure: A randomised study

Zhou¹,

Li²,

Zhang³

et al. 2015

Journal of Hepatology

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“…Different bioartificial liver support systems were used enthusiastically in small clinical trials [11-13] but in a multicenter study conducted by Demetrieu et al, they were found to improve the survival of patients with fulminant/subfulminant liver failure only after excluding primary nonfunction following liver transplantation which was included in the study group [14]. Finally, extracorporeal therapy with fractionated plasma Separation and Adsorption (Prometheus ® ) was associated with an improved survival in patients with acute liver failure, but mainly in retrospective and case report studies [15-17]. …”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Hepa Wash®treatment in pigs with acute liver failure

et al. 2013

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BackgroundMortality of patients with acute liver failure (ALF) is still unacceptably high. Available liver support systems are still of limited success at improving survival. A new type of albumin dialysis, the Hepa Wash® system, was newly introduced. We evaluated the new liver support system as well as the Molecular Adsorbent Recycling System (MARS) in an ischemic porcine model of ALF.MethodsIn the first study animals were randomly allocated to control (n=5) and Hepa Wash (n=6) groups. In a further pilot study, two animals were treated with the MARS-system. All animals received the same medical and surgical procedures. An intraparenchymal intracranial pressure was inserted. Hemodynamic monitoring and goal-directed fluid therapy using the PiCCO system was done. Animals underwent functional end-to-side portacaval shunt and ligation of hepatic arteries. Treatment with albumin dialysis was started after fall of cerebral perfusion pressure to 45 mmHg and continued for 8 h.ResultsAll animals in the Hepa Wash group survived the 13-hour observation period, except for one that died after stopping treatment. Four of the control animals died within this period (p=0.03). Hepa Wash significantly reduced impairment of cerebral perfusion pressure (23±2 vs. 10±3 mmHg, p=0.006) and mean arterial pressure (37±1 vs. 24±2 mmHg, p=0.006) but had no effect on intracranial pressure (14±1 vs. 15±1 mmHg, p=0.72). Hepa Wash also enhanced cardiac index (4.94±0.32 vs. 3.36±0.25 l/min/m2, p=0.006) and renal function (urine production, 1850 ± 570 vs. 420 ± 180 ml, p=0.045) and eliminated water soluble (creatinine, 1.3±0.2 vs. 3.2±0.3 mg/dl, p=0.01; ammonia 562±124 vs. 1382±92 μg/dl, p=0.006) and protein-bound toxins (nitrate/nitrite 5.54±1.57 vs. 49.82±13.27 μmol/l, p=0.01). No adverse events that could be attributed to the Hepa Wash treatment were observed.ConclusionsHepa Wash was a safe procedure and improved multiorgan system failure in pigs with ALF. The survival benefit could be the result of ameliorating different organ functions in association with the detoxification capacity of water soluble and protein-bound toxins.

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“…This is one of the largest series reporting the successful use of FPSA in AoCLF and ALF, with the exception of a recent report of a larger series [14]. In this study, we have shown that FPSA system can be used safely and efficiently not only in AoCLF but also in ALF.…”

Section: Discussionmentioning

confidence: 51%

The treatment of acute liver failure with fractionated plasma separation and adsorption system: Experience in 85 applications

Şentürk

Esen

Özcan

et al. 2010

J of Clinical Apheresis

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Results of Treatment of Acute Liver Failure Patients With Use of the Prometheus FPSA System

Cited by 40 publications

References 8 publications

Efficacy of coupled low-volume plasma exchange with plasma filtration adsorption in treating pigs with acute liver failure: A randomised study

Efficacy of coupled low-volume plasma exchange with plasma filtration adsorption in treating pigs with acute liver failure: A randomised study

Evaluation of the Hepa Wash®treatment in pigs with acute liver failure

The treatment of acute liver failure with fractionated plasma separation and adsorption system: Experience in 85 applications

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