Successful use of single‐pass albumin dialysis in the correction of severe hyperbilirubinemia in a case of acute hepatitis E

Piscitani, Luca; Vito, Roberto Di; Tunno, Marilena; Bonomini, Mario

doi:10.1111/1744-9987.13909

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…It may be related to various mediators including bile acids, endogenous opioid peptide, histamine and lysophosphatidic acid. Pruritogens cause itching through the activation of the G-protein-coupled receptors (GPCRs) and the transient receptor potential (TRP) ion channels on the afferent nerve endings in the skin (11).…”

Section: Discussionmentioning

confidence: 99%

Cholestatic viral hepatitis a with refractory pruritus successfully treated with a combination of molecular adsorbent recirculating system and corticosteroids: A case report

Đorđević,

Čanović,

Petrović

et al. 2023

Acta fac medic Naissensis

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Introduction. Hepatitis A virus is a major cause of acute viral hepatitis worldwide, with approximately 1.5 million cases annually. Clinical manifestations of the hepatitis A virus infection range from asymptomatic to acute liver failure. Cholestatic viral hepatitis A is a rare clinical manifestation characterized by a prolonged course, refractory pruritus, imminent acute liver failure and generally good prognosis. The treatment of pruritus in cholestatic viral hepatitis A can be challenging because a response to conventional therapy is limited. Case report. We present the effects of a combination of pulse doses of prednisolone and two cycles of MARS (Molecular Adsorbent Recirculating System) in the treatment of a young female patient with cholestatic viral hepatitis A. This treatment option significantly reduced the duration of the disease and the intensity of pruritus and led to full recovery of the patient and normalization of laboratory parameters of cholestasis. Conclusion. This treatment combination has proven to have significant and lasting effects with no relapse of pruritus. Low doses of corticosteroids administered for a short time reduce the risk of side effects. The importance of vaccination of international travellers should be also pointed out here.

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Section: Discussionmentioning

confidence: 99%

Cholestatic viral hepatitis a with refractory pruritus successfully treated with a combination of molecular adsorbent recirculating system and corticosteroids: A case report

Đorđević,

Čanović,

Petrović

et al. 2023

Acta fac medic Naissensis

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“…It is an inexpensive, widely available, simple technique that requires only a simple CRRT machine and exogenous albumin. Although an HCO filter has been reported to be used[ 68 ]; in most cases, a high-flux hemofilter is used as a dialyzer. The albumin-containing dialysate flows opposite to the blood in the filter, extracting the hydrophobic substances from the saturated albumin of the blood to the dialysate, which is subsequently disposed.…”

Section: Compination Modalitiesmentioning

confidence: 99%

Liver replacement therapy with extracorporeal blood purification techniques current knowledge and future directions

Papamichalis¹,

Oikonomou²,

Valsamaki³

et al. 2023

World J Clin Cases

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Clinically, it is highly challenging to promote recovery in patients with acute liver failure (ALF) and acute-on-chronic liver failure (ACLF). Despite recent advances in understanding the underlying mechanisms of ALF and ACLF, standard medical therapy remains the primary therapeutic approach. Liver transplantation (LT) is considered the last option, and in several cases, it is the only intervention that can be lifesaving. Unfortunately, this intervention is limited by organ donation shortage or exclusion criteria such that not all patients in need can receive a transplant. Another option is to restore impaired liver function with artificial extracorporeal blood purification systems. The first such systems were developed at the end of the 20 th century, providing solutions as bridging therapy, either for liver recovery or LT. They enhance the elimination of metabolites and substances that accumulate due to compromised liver function. In addition, they aid in clearance of molecules released during acute liver decompensation, which can initiate an excessive inflammatory response in these patients causing hepatic encephalopathy, multiple-organ failure, and other complications of liver failure. As compared to renal replacement therapies, we have been unsuccessful in using artificial extracorporeal blood purification systems to completely replace liver function despite the outstanding technological evolution of these systems. Extracting middle to high-molecular-weight and hydrophobic/protein-bound molecules remains extremely challenging. The majority of the currently available systems include a combination of methods that cleanse different ranges and types of molecules and toxins. Furthermore, conventional methods such as plasma exchange are being re-evaluated, and novel adsorption filters are increasingly being used for liver indications. These strategies are very promising for the treatment of liver failure. Nevertheless, the best method, system, or device has not been developed yet, and its probability of getting developed in the near future is also low. Furthermore, little is known about the effects of liver support systems on the overall and transplant-free survival of these patients, and further investigation using randomized controlled trials and meta-analyses is needed. This review presents the most popular extracorporeal blood purification techniques for liver replacement therapy. It focuses on general principles of their function, and on evidence regarding their effectiveness in detoxification and in supporting patients with ALF and ACLF. In addition, we have outlined the basic advantages and disadvantages of each system.

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Soportes actuales en falla hepática: cuando el trasplante se hace esperar

Nazal,

Valenzuela,

Ferre

2024

Revista Médica Clínica Las Condes

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Successful use of single‐pass albumin dialysis in the correction of severe hyperbilirubinemia in a case of acute hepatitis E

Cited by 3 publications

References 18 publications

Cholestatic viral hepatitis a with refractory pruritus successfully treated with a combination of molecular adsorbent recirculating system and corticosteroids: A case report

Cholestatic viral hepatitis a with refractory pruritus successfully treated with a combination of molecular adsorbent recirculating system and corticosteroids: A case report

Liver replacement therapy with extracorporeal blood purification techniques current knowledge and future directions

Soportes actuales en falla hepática: cuando el trasplante se hace esperar

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