Hepatocyte Suspension as a Biological Material for Extracorporeal Liver Support Systems

2017 ◽  
Vol 51 (4) ◽  
pp. 234-238
Author(s):  
V. E. Ryabinin ◽  
E. E. Polevschikova ◽  
P. N. Popkov ◽  
S. A. Pushkarev ◽  
A. I. Sinitskii ◽  
...  
Keyword(s):  
Biological Material ◽  
Support Systems ◽  
Liver Support ◽  
Extracorporeal Liver Support ◽  
Hepatocyte Suspension

Removal of Bile Acids by Two Different Extracorporeal Liver Support Systems in Acute-on-Chronic Liver Failure

ASAIO Journal ◽  
2007 ◽  
Vol 53 (2) ◽  
pp. 187-193 ◽  
Author(s):  
Vanessa Stadlbauer ◽  
Peter Krisper ◽  
Ulrich Beuers ◽  
Bernd Haditsch ◽  
Daniel Schneditz ◽  
...  
Keyword(s):  
Liver Failure ◽  
Bile Acids ◽  
Support Systems ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Liver Support ◽  
Extracorporeal Liver Support

scholarly journals Extracorporal methods for liver failure treatment

2014 ◽  
Vol 95 (1) ◽  
pp. 75-79 ◽  
Author(s):  
D E Kutepov
Keyword(s):  
Liver Failure ◽  
Support Systems ◽  
Isolated Hepatocytes ◽  
Liver Support ◽  
Failure Treatment ◽  
Molecular Adsorbent Recirculating System ◽  
Extracorporeal Liver Support ◽  
Long Time ◽  
Biological Methods ◽  
Molecular Adsorbent

A mortality rate in patients with liver failure remains high. Currently the main causes for liver failure are viral hepatitis and alcoholic liver disease. As a result of liver detoxification malfunction a number of complications, including hepatic encephalopathy, hepatorenal syndrome, circulatory disorders develop. Different types of extracorporeal therapies and their combination are used to treat the liver failure for a long time. Figuratively, extracorporeal liver support systems can be divided into two groups: biological and non-biological. Biological methods are based on the use of isolated hepatocytes suspension. Non-biological methods include dialysis, hemofiltration, plasma exchange, hemosorption, Molecular Adsorbent Recirculating System (MARS) and fractionated plasma separation and adsorption (FPSA or Prometheus). Modern technologies allowed to combine liver support systems into a whole and to create an additional method of liver failure treatment — Molecular Adsorbent Recirculating System (MARS). Currently, MARS is a promising trend of liver failure treatment, as it allows support the liver function for a long time until restored or an optimal donor will be found.

The place of adsorption and biochromatography in extracorporeal liver support systems

2008 ◽  
Vol 861 (2) ◽  
pp. 171-176 ◽  
Author(s):  
C. Legallais ◽  
A. Gautier ◽  
M. Dufresne ◽  
B. Carpentier ◽  
R. Baudoin
Keyword(s):  
Support Systems ◽  
Liver Support ◽  
Extracorporeal Liver Support

Overview of Extracorporeal Liver Support Systems and Clinical Results

1999 ◽  
Vol 875 (1) ◽  
pp. 310-325 ◽  
Author(s):  
BRIAN E. McLAUGHLIN ◽  
CHRISTINE M. TOSONE ◽  
LINDA M. CUSTER ◽  
CLAUDY MULLON
Keyword(s):  
Support Systems ◽  
Clinical Results ◽  
Liver Support ◽  
Extracorporeal Liver Support

scholarly journals Effects of Extracorporeal Liver Support Systems in Liver Failure

2012 ◽  
Vol 40 (5) ◽  
pp. 269-273
Author(s):  
Evren Senturk ◽  
Perihan Ergin Ozcan ◽  
Gunseli Orhun ◽  
Binnur Pinarbasi ◽  
Figen Esen ◽  
...  
Keyword(s):  
Liver Failure ◽  
Support Systems ◽  
Liver Support ◽  
Extracorporeal Liver Support

scholarly journals The Use of Extracorporeal Liver Support Systems In Acute Decompensated Liver Failure

2021 ◽  
Vol 17 (4) ◽  
pp. 12-21
Author(s):  
R. A. Ibadov ◽  
Ye. L. Ismailov ◽  
S. Kh. Ibragimov
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Organ Failure ◽  
Comparison Group ◽  
Support Systems ◽  
Intensive Therapy ◽  
Multiple Organ ◽  
Main Group ◽  
Liver Support ◽  
Extracorporeal Liver Support

The aim of the study: to evaluate the efficacy of extracorporeal liver support systems in patients with acute liver failure of various etiologies.Material and methods. The study included 117 patients with acute liver failure of various etiologies. The main group consisted of 71 patients who received complex intensive therapy, including MARS-therapy and hemodiafiltration. The comparison group included 46 patients who received albumin dialysis (24 patients) and hemodiafiltration (22 patients) alone. The mean age of the patients was 34±5.6 years, the majority (56.4%) were men. Dynamic assessment of patients' severity was performed using Sequential Organ Failure Assessment (SOFA) and Model for End-Stage Liver Disease (MELD) scales.Results. A more significant reduction of SOFA and MELD scores was noted as early as by day 10 of intensive therapy in the main group with sequential use of extracorporeal liver detoxification methods — to 2.7±0.2 vs. 8.3±0.5 points (P=0.021) on SOFA and to 16.7±0.4 vs. 23.4±1.4 points (P=0.023) MELD scales. The use of a comprehensive approach to extracorporeal detoxification in acute decompensated liver failure increased the regression rate of multiple organ failure from 51.2 to 74.6% and reduced mortality from 47.8 to 25.4% (χ2=6.266; df=1; P=0.013). At the same time, the cumulative proportion of survivors depending on the type of complication within 30 days was 88.4% in the main group and 69.0% in the comparison group (χ2=4.164; df=1; P=0.042).Conclusion. A comprehensive approach to extracorporeal detoxification is highly effective, providing a more significant reduction of SOFA and MELD scores, increasing the proportion of regression of multiple organ dysfunction and reducing mortality.

scholarly journals Uncertainty in the impact of liver support systems in acute-on-chronic liver failure: a systematic review and network meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Klementina Ocskay ◽  
Anna Kanjo ◽  
Noémi Gede ◽  
Zsolt Szakács ◽  
Gabriella Pár ◽  
...  
Keyword(s):  
Liver Failure ◽  
Support Systems ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Bioartificial Liver ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Liver Support ◽  
Bioartificial Liver Support ◽  
The Impact

Abstract Background The role of artificial and bioartificial liver support systems in acute-on-chronic liver failure (ACLF) is still controversial. We aimed to perform the first network meta-analysis comparing and ranking different liver support systems and standard medical therapy (SMT) in patients with ACLF. Methods The study protocol was registered with PROSPERO (CRD42020155850). A systematic search was conducted in five databases. We conducted a Bayesian network meta-analysis of randomized controlled trials assessing the effect of artificial or bioartificial liver support systems on survival in patients with ACLF. Ranking was performed by calculating the surface under cumulative ranking (SUCRA) curve values. The RoB2 tool and a modified GRADE approach were used for the assessment of the risk of bias and quality of evidence (QE). Results In the quantitative synthesis 16 trials were included, using MARS®, Prometheus®, ELAD®, plasma exchange (PE) and BioLogic-DT®. Overall (OS) and transplant-free (TFS) survival were assessed at 1 and 3 months. PE significantly improved 3-month OS compared to SMT (RR 0.74, CrI: 0.6–0.94) and ranked first on the cumulative ranking curves for both OS outcomes (SUCRA: 86% at 3 months; 77% at 1 month) and 3-month TFS (SUCRA: 87%) and second after ELAD for 1-month TFS (SUCRA: 76%). Other comparisons did not reach statistical significance. QE was moderate for PE concerning 1-month OS and both TFS outcomes. Other results were of very low certainty. Conclusion PE seems to be the best currently available liver support therapy in ACLF regarding 3-month OS. Based on the low QE, randomized trials are needed to confirm our findings for already existing options and to introduce new devices.

scholarly journals Impact of anion exchange adsorbents on regional citrate anticoagulation

2020 ◽  
pp. 039139882094773
Author(s):  
Karin Strobl ◽  
Stephan Harm ◽  
Ute Fichtinger ◽  
Claudia Schildböck ◽  
Jens Hartmann
Keyword(s):  
Anion Exchange ◽  
Regional Citrate Anticoagulation ◽  
Liver Support ◽  
Anion Exchange Resins ◽  
Increased Risk ◽  
Extracorporeal Liver Support ◽  
Target Molecules ◽  
Exchange Resins ◽  
The Impact

Introduction: Heparin and citrate are commonly used anticoagulants in membrane/adsorption based extracorporeal liver support systems. However, anion exchange resins employed for the removal of negatively charged target molecules including bilirubin may also deplete these anticoagulants due to their negative charge. The aim of this study was to evaluate the adsorption of citrate by anion exchange resins and the impact on extracorporeal Ca2+ concentrations. Methods: Liver support treatments were simulated in vitro. Citrate and Ca2+ concentrations were measured pre and post albumin filter as well as pre and post adsorbents. In addition, batch experiments were performed to quantify citrate adsorption. Results: Pre albumin filter target Ca2+ concentrations were reached well with only minor deviations. Citrate was adsorbed by anion exchange resins, resulting in a higher Ca2+ concentration downstream of the adsorbent cartridges during the first hour of treatment. Conclusions: The anion exchange resin depletes citrate, leading to an increased Ca2+ concentration in the extracorporeal circuit, which may cause an increased risk of clotting during the first hour of treatment. An increase of citrate infusion during the first hour of treatment should therefore be considered to compensate for the adsorption of citrate.

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