Use of Hemoadsorption in a Case of Severe Hepatic Failure and Hyperbilirubinemia

Faltlhauser, Andreas; Kullmann, Frank

doi:10.1159/000470826

Cited by 13 publications

(7 citation statements)

References 5 publications

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“…CytoSorb ® may be efficient in rebalancing the immune system in patients with high levels of pro-inflammatory cytokines. 14,15 The observed decrease in C-reactive protein levels offers a promising insight into the treatment options for the severe SIRS that accompanies ALF. This is in accordance with previous published case reports that demonstrated a decrease in other pro-inflammatory cytokines in patients undergoing cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

Haemoadsorption by CytoSorb® in patients with acute liver failure: A case series

et al. 2020

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Acute liver failure (ALF) is a life-threatening disease associated with multi-organ failure and increased mortality. Severe inflammation is now considered the main pathophysiological mechanism for organ dysfunction, thus rebalancing pro- and anti- inflammatory cytokines may improve liver function and outcome. The aim of this study was to assess the clinical effects of a haemoadsorption column on biochemical parameters in patients with ALF. We prospectively included 28 patients with ALF who were treated with three consecutive sessions of continuous venovenous haemofiltration in combination with CytoSorb®. Our results show an improvement in liver functional tests and a decrease in Creactive protein. Thrombocytopenia remains one of the most important side effects of this treatment and careful consideration should be made before initiation of treatment.

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Section: Discussionmentioning

confidence: 99%

Haemoadsorption by CytoSorb® in patients with acute liver failure: A case series

et al. 2020

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“…5 Observations during Cytosorb use noted significant reductions in plasma bilirubin, a therapeutic approach our group have explored previously using a complex high-flux haemofiltration system. 6 Our experience with Cytosorb in managing sepsis along with early published reports of similar effects and the desire for a simpler system to clear the toxins of liver failure 7,8 led us to evaluate the device to support liver failure secondary to drug-induced cholestasis and acute alcoholic hepatitis. These were felt appropriate disease models as spontaneous liver recovery was expected over a period of months but these patients experienced very severe symptoms (e.g.…”

Section: Introductionmentioning

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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“…In patients with multiorgan failure after surgery, the system is a promising therapeutic choice for critically ill and may help in cytokine reduction, improving organ function. 21,23…”

Section: Discussionmentioning

confidence: 99%

An unusual complication after endovascular aneurysm repair for giant abdominal aortic aneurysm with aortocaval fistula: High bilirubin levels

Marchetti

Oddi

Diotallevi

et al. 2020

SAGE Open Medical Case Reports

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Abdominal aortic aneurysm has among its rare complications the aortocaval fistula. It is observed in less than 1% of all abdominal aortic aneurysms and represents 3%–7% of clinical presentation in case of rupture. A male patient was presented to the emergency department with pulsating mass with continuous vascular systo-diastolic bruit, located in the lower part of abdomen with the back pain radiating anteriorly in lower abdomen. After diagnosis of abdominal aortic aneurysm with aortocaval fistula, a trimodular Endurant endograft was placed. Migration of the endoprosthesis was treated with Endoanchor and endovascular aneurysm sealing device. In the postoperative course, the patient had jaundice due to high bilirubin levels, cholestasis and increased hepatocyte cytolysis: aspartate aminotransferase and alanine aminotransferase. The treatment with appropriate continuous filtration rapidly reduced bilirubin values and the patient gradually improved.

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Use of Hemoadsorption in a Case of Severe Hepatic Failure and Hyperbilirubinemia

Cited by 13 publications

References 5 publications

Haemoadsorption by CytoSorb® in patients with acute liver failure: A case series

Haemoadsorption by CytoSorb® in patients with acute liver failure: A case series

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

An unusual complication after endovascular aneurysm repair for giant abdominal aortic aneurysm with aortocaval fistula: High bilirubin levels

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