scholarly journals The use of hemosorption in liver failure

1981 ◽  
Vol 62 (5) ◽  
pp. 6-9
Author(s):  
V. A. Sitnikov ◽  
V. V. Trusov ◽  
V. A. Lysenko ◽  
A. A. Ivanenkov
Keyword(s):  
Obstructive Jaundice ◽  
Liver Failure ◽  
Hepatic Failure ◽  
Hepatic Coma ◽  
Biliary Cirrhosis ◽  
Serum Hepatitis

The hemosorption method was applied in the treatment of 20 patients (30 hemosorptions). Indications for hemosorption were severe cholemic intoxication and liver failure in obstructive jaundice of gallstone and tumor etiology, hepatic coma in serum hepatitis, cholemic intoxication and liver failure in biliary cirrhosis, eclampsia and renal-hepatic failure. The efficiency and possible complications of hemosorption have been analyzed.

Plasmapheresis in Acute Liver Failure

1986 ◽  
Vol 9 (6) ◽  
pp. 433-438 ◽  
Author(s):  
J.G. Freeman ◽  
K. Matthewson ◽  
C.O. Record
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Hepatic Failure ◽  
Serum Bilirubin ◽  
Hepatic Coma ◽  
Acute Hepatic Failure ◽  
Plasma Ammonia ◽  
Coma Grade ◽  
Better Than

A series of 9 patients with acute hepatic failure and Grade IV hepatic coma received daily plasmapheresis until they recovered or death ensued. Of the nine, seven (77%) showed an improvement in coma grade and five (55%) survived to leave hospital. Plasmapheresis significantly decreased serum bilirubin, asparate aminotransferase and plasma ammonia concentrations. Survival following plasmapheresis appeared substantially better than in a non randomized group of similar patients not plasmapheresed. The simplicity of the procedure, biochemical improvements observed and apparent efficacy, suggest that further evaluation of the technique as a means of providing temporary hepatic support is indicated.

scholarly journals Analysis of the safety of pretransplant corticosteroid therapy in patients with acute liver failure and late‐onset hepatic failure in Japan

JGH Open ◽  
2021 ◽  
Vol 5 (4) ◽  
pp. 428-433
Author(s):  
Takuro Hisanaga ◽  
Isao Hidaka ◽  
Isao Sakaida ◽  
Nobuaki Nakayama ◽  
Akio Ido ◽  
...  
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Corticosteroid Therapy ◽  
Hepatic Failure ◽  
Late Onset ◽  
Late Onset Hepatic Failure

CTLA4 AND MMP1 POLYMORPHISMS DISTRIBUTION IN PRIMARY BILIARY CIRRHOSIS RAPIDLY EVOLVING TO LIVER FAILURE

2009 ◽  
Vol 41 ◽  
pp. S104
Author(s):  
A. Paziale ◽  
M. Cicilano ◽  
P. Pazienza ◽  
E. Tarabra ◽  
G. Actis ◽  
...  
Keyword(s):  
Primary Biliary Cirrhosis ◽  
Liver Failure ◽  
Biliary Cirrhosis

Acute Fulminant Hepatic Failure in a Woman Treated With Phenytoin and Trimethoprim-Sulfamethoxazole

2000 ◽  
Vol 124 (12) ◽  
pp. 1800-1803 ◽  
Author(s):  
Marius J-M. Ilario ◽  
Jose E. Ruiz ◽  
Constantine A. Axiotis
Keyword(s):  
Liver Injury ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Fulminant Hepatic Failure ◽  
Hepatic Failure ◽  
Acute Hepatic Failure ◽  
Hepatic Necrosis ◽  
Rare Occurrence ◽  
Autopsy Findings ◽  
Massive Hepatic Necrosis

Abstract Massive hepatic necrosis following exposure to phenytoin and trimethoprim-sulfamethoxazole is a rare occurrence and to the best of our knowledge has not been reported previously. Acute hepatic failure following administration of trimethoprim-sulfamethoxazole has rarely been seen, and only 4 cases have been well documented pathologically. We report a case of acute liver failure in a 60-year-old woman following ingestion of phenytoin and trimethoprim-sulfamethoxazole concomitantly over a 9-day period. Autopsy findings revealed acute fulminant hepatic failure. This case demonstrates the effects of chemical-chemical interactions in the potentiation of hepatotoxicity of single agents and specifically illustrates the need for discontinuing trimethoprim-sulfamethoxazole in the presence of early liver injury.

scholarly journals Endoscopic surgeries and correction of homeostasis disorders in patients with obstructive jaundice

2015 ◽  
Vol 96 (3) ◽  
pp. 444-447
Author(s):  
I S Malkov ◽  
G R Zakirov ◽  
V N Korobkov ◽  
M N Nasrullayev
Keyword(s):  
Obstructive Jaundice ◽  
Liver Failure ◽  
Biliary Tract ◽  
Comprehensive Treatment ◽  
Treatment Results ◽  
Endoscopic Papillotomy ◽  
Invasive Approach ◽  
Endoscopic Techniques ◽  
Endoscopic Methods ◽  
Pancreatic Sphincterotomy

Aim. To improve the treatment results of patients with obstructive jaundice using endoscopic methods for restoring biliary tract patency. Methods. A retrospective analysis of treatment results of 636 patients, treated in the surgical departments of City Clinical Hospital №7, Kazan, Russia in 2004-2014 with obstructive jaundice induced by tumors and other diseases was performed. Results. It was revealed that using endoscopic techniques for biliary system decompression allows to improve the treatment results. Our observations of patients 2014 with obstructive jaundice induced by tumors and other diseases suggest that the most important element of a comprehensive treatment of such patients is the earliest possible biliary tract decompression using minimally invasive approach, including endoscopic papillotomy and biliary tract stenting. The liver failure stage is an important criterion that defines patient management in case of obstructive jaundice. In patients with obstructive jaundice, treatment of endogenous toxemia and liver failure, according to the contemporary approaches, is based on drug administration and infusions of the required volume and contents, associated with one of the methods for biliary decompression therapy adequate in its formula and size. Conclusion. Endoscopic surgeries are indicated in the majority of acute, recurrent, and chronic large duodenal papilla obstruction cases. Performing endoscopic retrograde cholangiopancreatography, endoscopic pancreatic sphincterotomy in obstructive jaundice not associated with biliary tumors may refuse the surgical approach or reduce its volume and surgical injury.

scholarly journals Effect of the Hepatocyte-Specific Deletion of SND1 in Mice on the Liver Insulin Resistance and Acute Liver Failure

2020 ◽  
Author(s):  
Chunyan Zhao ◽  
Xiaoteng Cui ◽  
Baoxin Qian ◽  
Nan Zhang ◽  
Lingbiao Xin ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Cholesterol Level ◽  
Hepatic Steatosis ◽  
Glucose Homeostasis ◽  
Hepatic Failure ◽  
High Fat Diet ◽  
High Fat ◽  
Specific Deletion

Abstract Background: The multifunctional protein SND1 was reported to be involved in a variety of biological processes, such as cell cycle, proliferation or lipogenesis. We previously proposed that global-expressed SND1 in vivo is likely to be a key regulator for ameliorating HFD-induced hepatic steatosis and systemic insulin resistance. Herein, we are very interested in investigating further whether the hepatocyte-specific deletion of SND1 affects the insulin resistance or acute liver failure (ALF) of mice.Methods: By using Cre-loxP technique, we constructed conditional knockout (LKO) mice of SND1 driven by albumin in hepatocytes and analyze the changes of glucose homeostasis, cholesterol level, hepatic steatosis and hepatic failure under the treatment of high-fat diet (HFD) or upon the simulation of Lipopolysaccharide/galactosamine (LPS/GalN).Results: No difference for the body weight, liver weight, and cholesterol level was detected. Furthermore, we did not observe the alteration of glucose homeostasis in SND1 hepatic knockout mice on either chow diet or high-fat diet. Besides, hepatocyte-specific deletion of SND1 failed to influence the hepatic failure of mice induced by LPS/GalN.Conclusions: These findings suggest that hepatic SND1, independently, is insufficient for changing glucose homeostasis, hepatic lipid accumulation and inflammation. The synergistic action of multiple organs may contribute to the role of SND1 in insulin sensitivity or inflammatory response.

SURGICAL EXPLORATION IN OBSTRUCTIVE JAUNDICE OF INFANCY

PEDIATRICS ◽  
1960 ◽  
Vol 26 (1) ◽  
pp. 27-35
Author(s):  
Thomas V. Santulli ◽  
Ruth C. Harris ◽  
Keith Reemtsma
Keyword(s):  
Differential Diagnosis ◽  
Obstructive Jaundice ◽  
Bile Ducts ◽  
Frozen Section ◽  
Surgical Trauma ◽  
Bile Pigment ◽  
Biliary Cirrhosis ◽  
Intestinal Anastomoses ◽  
Surgical Exploration ◽  
Frozen Section Examination

From a review of 71 cases and an evaluation of frozen-section examinations of liver biopsies, the authors propose the following method of management of infants with prolonged obstructive jaundice. All patients are carefully selected on the basis of history, clinical findings and appropriate laboratory investigation. Laboratory studies found to aid in the differential diagnosis are: serial determinations of bilirubin (conjugated and unconjugated) in the serum, zinc sulfate turbidity test, cholesterol and cholesterol esters in serum, estimation of bile pigment in urine and stool, studies of the maternal and infant blood factors and erythrocyte fragility. Determinations that have not been useful in the differential diagnosis are: cholesterol esterase, alkaline phosphatase and cephalin fiocculation.19 The activity of transaminases in the serum may prove helpful and are currently under study. The measurement of the prothrombin time should be included in the preoperative studies. If the diagnosis is impossible by the age of 7 weeks, then surgical exploration is carried out. This consists of exposing the liver, taking a biopsy for frozen-section examination and performing a cholangiogram, if possible. With increasing experience, confidence has been acquired in interpretation of the frozen-section of the liver biopsy at this age. The authors are convinced of its value in helping the surgeon establish the diagnosis before proceeding with further exploration of the bile ducts. By this method of management, surgical exploration need not be delayed beyond 7 weeks of age. Thus a patient with congenital atresia of the bile ducts, who may be fortunate enough to have a correctable lesion, will not be deprived of the only possible chance of cure. At this age it is unlikely that biliary cirrhosis will have progressed to a severe degree. Admittedly, it would be preferable to explore such a case earlier, but more experience is needed in diagnosis by frozen-section examination at an earlier age. It does not appear that any patient with hepatitis or other non-surgical condition has been harmed either by the anesthesia or surgical trauma attendant on this limited procedure. One of the greatest advantages of the frozen-section examination has been the information provided to the surgeon at a crucial time during the exploration. With this information the surgeon should be able to avoid unnecessary exploration of the bile ducts and possible injury to patent ducts, as well as unnecessary biliary-intestinal anastomoses which have been performed in the past because of mistaken diagnoses.

Acute Hepatic Failure

2019 ◽  
Author(s):  
Derek J Erstad ◽  
Motaz Qadan
Keyword(s):  
Intensive Care ◽  
Respiratory Distress Syndrome ◽  
Liver Failure ◽  
Respiratory Distress ◽  
Acute Liver Failure ◽  
Fulminant Hepatic Failure ◽  
Cerebral Edema ◽  
Hepatic Failure ◽  
Distress Syndrome ◽  
Diagnosis And Management

Acute liver failure (ALF) is a rare but highly morbid condition that is optimally managed by a multidisciplinary team of surgeons, hepatologists, and intensivists at a tertiary care center that specializes in liver disorders. ALF is caused by four primary mechanisms, including viral infections (most commonly Hepatitis A and B); toxicity from acetaminophen overdose or other substances; postoperative hepatic failure ; and miscellaneous causes such as autoimmune hepatitis, genetic disorders, or idiopathic etiologies. Unlike chronic liver failure in which the body develops compensatory, protective mechanisms, ALF may be associated with severe multisystem organ involvement, including respiratory distress syndrome, renal failure, and cerebral edema. Fulminant hepatic failure represents a rapidly progressive form of ALF that portends worse prognosis. Prompt diagnosis and management of multisystem organ dysfunction in an intensive care setting is paramount to survival. However, a subset of patients will fail to improve with medical management alone. Early identification of these individuals for emergent transplant listing has been shown to improve outcomes. Multiple predictive models for ALF survival have been developed, which are based on weighted evaluation of clinical and laboratory parameters. These models may be used to facilitate treatment, predict prognosis, and guide transplant listing. In this chapter, we provide an in-depth review these concepts, focusing on the classification, epidemiology, diagnosis, and management of ALF. This review contains 5 tables and 69 references. Key Words: acute liver failure, acute respiratory distress syndrome, coagulopathy, cerebral edema, fulminant hepatic failure, hepatic necrosis, liver transplantation, metabolic disarray, multidisciplinary intensive care, prognostication

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