Artificial liver support in acute liver injury and graft dysfunction: MARS increases short-term response to therapy and predicts further course of disease

2017 ◽  
Author(s):  
U Gerth ◽  
G Thölking ◽  
A Hüsing-Kabar ◽  
I Kabar ◽  
H Schmidt ◽  
...  
Keyword(s):  
Liver Injury ◽  
Acute Liver Injury ◽  
Response To Therapy ◽  
Artificial Liver ◽  
Graft Dysfunction ◽  
Short Term ◽  
Liver Support ◽  
Artificial Liver Support ◽  
Course Of Disease ◽  
Term Response

scholarly journals Characterization of an Artificial Liver Support System-Related Vasovagal Reaction

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Shanshan Ma ◽  
Zhongyang Xie ◽  
Huafen Zhang ◽  
Jiangcheng Rong ◽  
Lingjian Zhang ◽  
...  
Keyword(s):  
Liver Injury ◽  
Support System ◽  
Artificial Liver ◽  
Severe Liver ◽  
Liver Support ◽  
Artificial Liver Support ◽  
Vasovagal Reaction ◽  
Liver Support System ◽  
Artificial Liver Support System ◽  
Associated Symptoms

Objective. An artificial liver support system (ALSS) is an effective therapy for patients with severe liver injury. A vasovagal reaction (VVR) is a common complication in various treatment settings but has not been reported previously in ALSS. Methods. This study retrospectively evaluated patients who suffered an ALSS-related VRR between January 2018 and June 2019. We collected data from VVR episodes including onset time, duration, changes in heart rate (HR) and blood pressure (BP), and drug treatment. Results. Among 637 patients who underwent ALSS treatment, 18 were included in the study. The incidence of VVR was approximately 2.82%. These patients were characterized by a rapid decrease in BP or HR with associated symptoms such as chest distress, nausea, and vomiting. The majority of patients (78%) suffered a VVR during their first ALSS treatment. Sixteen patients (89%) had associated symptoms after treatment began. Sixteen patients (89%) received human albumin or Ringer’s solution. Atropine was used in 11 patients (61%). The symptoms were relieved within 20 min in 15 patients and over 20 min in 3 patients. Conclusions. A VVR is a rare complication in patients with severe liver injury undergoing ALSS treatment. Low BP and HR are the main characteristics of a VVR.

scholarly journals Artificial Liver Support System Improves Short-Term Outcomes of Patients with HBV-Associated Acute-on-Chronic Liver Failure: A Propensity Score Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Lan-Lan Xiao ◽  
Xiao-Wei Xu ◽  
Kai-Zhou Huang ◽  
Ya-Lei Zhao ◽  
Ling-Jian Zhang ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Propensity Score ◽  
Survival Rates ◽  
Artificial Liver ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Liver Support ◽  
Artificial Liver Support ◽  
Liver Support System ◽  
Artificial Liver Support System

Background. Hepatitis B virus-associated acute-on-chronic liver failure (HBV-ALCF) is a complicated syndrome with extremely high short-term mortality. The artificial liver support system (ALSS) may improve the liver function for patients with HBV-ACLF, but the data on its short-term outcomes are insufficient in China. Methods. We recruited HBV-ACLF patients in this nationwide, multicenter, retrospective study. Patients with HBV-ACLF were diagnosed by the COSSH-ACLF criteria. Propensity score matching (PSM) analysis was used to generate compared pairs. The short-term (28/90 days) survival rates between the standard medical therapy (SMT) group and ALSS group were calculated using a Kaplan–Meier graph. Result. In total, 790 patients with HBV-ACLF were included in this retrospective study; 412 patients received SMT only (SMT group), and 378 patients received SMT and ALSS treatment (ALSS group). PSM generated 310 pairs and eliminated the baseline differences between the two groups (p>0.05 for all baseline variables). The probabilities of survival on day 28 were 65.2% (205/310) in the ALSS group and 59.0% (185/310) in the SMT group; on day 90, they were 51.0% (163/310) and 42.3% (136/310). The short-term (28/90 days) survival rates of the ALSS group were significantly higher than those of the SMT group (p=0.0452 and p=0.0187, respectively). Compared to receiving SMT alone, treatment with ALSS was associated with a significant reduction in serum bilirubin levels and the model for end-stage liver disease (MELD) scores at day 7 and day 28. Multivariate logistic regression analysis revealed that older age, high total bilirubin (T-Bil), low albumin, high ALT, high MELD scores, and high COSSH-ACLF grade were independent baseline factors associated with poor prognosis. Conclusions. This retrospective study found that compared to SMT, the ALSS improved the short-term (28/90 days) survival rates and laboratory parameters in HBV-ACLF patients. The ALSS had a better therapeutic effect than SMT for patients with HBV-ACLF in China.

scholarly journals Extracorporeal artificial liver support in hypoxic liver injury

2011 ◽  
Vol 31 ◽  
pp. 19-23 ◽  
Author(s):  
Andreas Drolz ◽  
Reinhard Saxa ◽  
Thomas Scherzer ◽  
Valentin Fuhrmann
Keyword(s):  
Liver Injury ◽  
Artificial Liver ◽  
Liver Support ◽  
Artificial Liver Support ◽  
Hypoxic Liver Injury

Fructus Psoraleae–Induced Severe Liver Injury and Treatment With Two Artificial Liver Support Systems: A Case Series Study

2019 ◽  
Vol 24 (3) ◽  
pp. 324-332
Author(s):  
Jiangcheng Rong ◽  
Zhongyang Xie ◽  
Ermei Chen ◽  
Shanshan Ma ◽  
Sainan Zhang ◽  
...  
Keyword(s):  
Liver Injury ◽  
Support Systems ◽  
Case Series ◽  
Artificial Liver ◽  
Severe Liver ◽  
Liver Support ◽  
Artificial Liver Support ◽  
Case Series Study ◽  
Series Study

scholarly journals Anti-tuberculosis drug-induced acute liver failure requiring transplantation in the second trimester of pregnancy: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhoufeng Zhu ◽  
Min Zhang ◽  
Yang Li
Keyword(s):  
Liver Transplantation ◽  
Liver Injury ◽  
Liver Failure ◽  
Artificial Liver ◽  
Drug Induced ◽  
Liver Support ◽  
Artificial Liver Support ◽  
Liver Support System ◽  
Tb Treatment ◽  
Artificial Liver Support System

Abstract Background Treatment of tuberculosis (TB) during pregnancy can reduce maternal and foetal complications. However, it may also induce fatal liver injury. Case presentation We present a case of a 26-year-old pregnant woman who underwent orthotopic liver transplantation for anti-TB drug-induced fulminant hepatic failure (FHF). Her tuberculous pleurisy was treated with rifampin, isoniazid and pyrazinamide. An artificial liver support system (ALSS) was unable to reverse the liver injury while serving as a bridge to liver transplantation. She had a successful liver transplantation operation at 17 3/7 weeks of gestation. The foetal ultrasound scan showed mild foetal bilateral ventriculomegaly at 21 5/7 weeks of gestation, and labour was induced via double-balloon catheter as soon as the allograft function was stable. Despite immunosuppression, the TB was well controlled with linezolid, levofloxacin and pyridoxine at the 8 months follow-up. Conclusions Anti-TB drug-induced liver failure during pregnancy is rare. We present a case of successful treatment of FHF in which an artificial liver support system combined with liver transplantation. The FHF was caused by anti-TB drugs with difficulties due to pregnancy status and post-transplant anti-TB treatment. Mild foetal ventriculomegaly was found in our case. Further research is still needed to identify the risks of TB treatment and liver transplantation in pregnant women. A multidisciplinary team coordinated properly to optimize patient outcomes.

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