The Use of High-Flux Albumin Haemofiltration (HFAF) with Evaclio EC-2C™ in the Management of Liver Failure as a Bridge to Transplantation

Morris, C.; Rogerson, David

doi:10.1177/175114371101200310

Cited by 5 publications

(5 citation statements)

References 10 publications

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“…Our group in Derby has previously investigated high flux albumin filtration, and the clearance rates of bilirubin appear broadly comparable to Cytosorb and MARS. 20 The Cytosorb column was originally marketed for sepsis management and we have described our early experiences in this setting. 2 However, the polymer bead technology shares similarities with the anion exchange column component of the MARS circuit and the Cytosorbent team suspected liver toxin clearance would be occur in clinical use (personal communication, Christian Steiner, Cytosorbents).…”

Section: Discussionmentioning

confidence: 99%

Novel use of Cytosorb™ haemadsorption to provide biochemical control in liver impairment

Dhokia

Madhavan

Austin

et al. 2018

Journal of the Intensive Care Society

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We describe the use of Cytosorb TM , a synthetic extracorporeal haemoperfusion adsorption column, in the management of two patients with drug induced cholestasis and a third with alcoholic hepatitis and subsequent acute on chronic liver failure. Cytosorb was used in these patients to remove bilirubin and bile acids by supporting impaired excretory hepatic function, alleviating symptoms with the intention of serving as a bridge to endogenous recovery. The first two cases demonstrate favourable biochemical and symptomatic responses; the third case demonstrated a good biochemical response but subsequently died from the complications of multiple organ failure. These cases suggest Cytosorb TM be evaluated as an adjunct to support liver excretory functions in other arenas, such as acute liver failure or overdose. It remains unclear whether extracorporeal therapies removing liver toxins allow faster or more complete spontaneous recovery of endogenous function.

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Section: Discussionmentioning

confidence: 99%

Novel use of Cytosorb™ haemadsorption to provide biochemical control in liver impairment

Dhokia

Madhavan

Austin

et al. 2018

Journal of the Intensive Care Society

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“…Often complex arrangements of therapy and expensive with use of blood products. We described Evaclio EC-2C high flux haemofiltration in supporting liver failure, partly exploiting its ability to clear cytokines 32 As UK-trained clinicians this has been our first clinical experience using assays of IL-6 during sepsis, and anecdotally this is typical. Neither case demonstrated a rapid response during Cytosorb TM and the pattern was one of ''gradual improvement'' over hours; definitively ascribing causality is premature.…”

Section: Discussionmentioning

confidence: 99%

Early report: The use of Cytosorb™ haemabsorption column as an adjunct in managing severe sepsis: initial experiences, review and recommendations

Morris

Gray

Giovannelli

2015

Journal of the Intensive Care Society

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A novel synthetic haemabsorption column (Cytosorb TM ) has recently become commercially available. We describe its use in patients with overwhelming sepsis and consider the experience and evidence supporting its use. While Cytosorb haemabsorption is mechanistically distinct from other extracorporeal therapies in sepsis and appears effective in reducing inflammatory cytokines during sepsis, much of the basic science and clinical benefits remain unclear. Significant interactions including removal of antibiotics may be harmful and require further study. Suggestions for future research and how Cytosorb TM could be incorporated into practice are provided.

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“…Albumin apheresis has rarely been used thus far in the management of liver failure. Besides our earlier experience with the SEPET™ hemofiltration device, very few case reports exist on treating liver failure using albumin‐leaking dialyzers and filters . Albumin replacement therapy is also advocated by the Jalan group, University College London (London, UK).…”

Section: Discussionmentioning

confidence: 99%

“…Currently, high‐performance hemofiltration with or without plasma exchange is being explored for liver support as a bridge therapy to regeneration or liver transplantation . We have previously described a treatment modality involving selective plasma filtration/exchange ( “ SEPET ” ) .…”

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confidence: 99%

Albumin Apheresis for Artificial Liver Support: In Vitro Testing of a Novel Filter

et al. 2018

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Currently there is no direct therapy for liver failure. We have previously described selective plasma exchange therapy using a hemofilter permeable to substances that have a molecular mass of up to 100 kDa. The proof-of-concept studies and a Phase I study in patients with decompensated cirrhosis demonstrated that hemofiltration using an albumin-leaking membrane is safe and effective in removing target molecules, alleviating severe encephalopathy and improving blood chemistry. In this study a novel large-pore filter for similar clinical application is described. The performance of the filter was studied in vitro; it was found to effectively remove a wide spectrum of pathogenic factors implicated in the pathophysiology of hepatic failure, including protein bound toxins and defective forms of circulating albumin. Data on mass transport characteristics and functionality using various modes of filtration and dialysis provide rationale for clinical evaluation of the filter for artificial liver support using albumin apheresis.

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The Use of High-Flux Albumin Haemofiltration (HFAF) with Evaclio EC-2C™ in the Management of Liver Failure as a Bridge to Transplantation

Cited by 5 publications

References 10 publications

Novel use of Cytosorb™ haemadsorption to provide biochemical control in liver impairment

Novel use of Cytosorb™ haemadsorption to provide biochemical control in liver impairment

Early report: The use of Cytosorb™ haemabsorption column as an adjunct in managing severe sepsis: initial experiences, review and recommendations

Albumin Apheresis for Artificial Liver Support: In Vitro Testing of a Novel Filter

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