A Case-Control Study of Single-Pass Albumin Dialysis for Acetaminophen-Induced Acute Liver Failure

Karvellas, Constantine J.; Bagshaw, Sean M.; McDermid, Robert C.; Stollery, Daniel; Bain, Vincent G.; Gibney, R. T. Noel

doi:10.1159/000227280

Cited by 40 publications

(29 citation statements)

References 75 publications

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“…In a retrospective study, MARS and SPAD showed equal efficacy . In ALF, SPAD was well tolerated, but it failed to improve survival and did not change referral to liver transplantation . In a single‐center experience from Germany, SPAD did not have any impact on survival or transplantation rate in patients with ACLF listed for transplantation .…”

Section: Currently Available Elsdsmentioning

confidence: 93%

Extracorporeal liver support devices for listed patients

Lee¹,

Stadlbauer

Jalan

2016

Liver Transpl

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An alternative to liver transplantation for patients with liver failure remains an unmet need. In acute liver failure, the ideal extracorporeal liver support device (ELSD) would replace the functions of the failing liver in order to permit spontaneous recovery, given the incredible regenerative potential of the liver, negating the need for transplantation. In acute‐on‐chronic liver failure, an ELSD would ideally support hepatic function until a recovery to liver function before acute decompensation or until liver transplantation. In decompensated cirrhosis, an ELSD could again be used to support hepatic function until transplant. In addition, ELSDs may have the potential to treat the multiorgan failure that accompanies liver failure including hepatic encephalopathy, renal failure, and immune dysfunction or indeed potential to promote liver regeneration. Creation of an extracorporeal bioartificial liver able to completely replace liver function remains an unmet need. This review will describe a number of technologies suitable for clinical trials in humans, which have resulted from decades of engineering and biological research to develop a bioreactor able to adequately sustain functional hepatocytes. In addition, this review will describe artificial liver support devices that are primarily designed to replace the detoxifying functions of the liver and will consider the current data available or studies required to support their use in liver failure patients on the transplant waiting list. Liver Transplantation 22 839–848 2016 AASLD.

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Section: Currently Available Elsdsmentioning

confidence: 93%

Extracorporeal liver support devices for listed patients

Lee¹,

Stadlbauer

Jalan

2016

Liver Transpl

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“…The DCCM has had an interest in kidney dysfunction associated with severe liver disease and has described the use of single pass albumin dialysis, initiated a molecular adsorbent recirculation system program and is evaluating the use of intraoperative CRRT during cadaveric orthotopic liver transplantation [22][23][24] . In addition, the DCCM has recruited an intensivist with training in gastroenterology and hepatology, Dr. Constantine (Dean) Karvellas, thereby opening further opportunities in the investigation and treatment of severe hepatic disease and kidney disease associated with liver failure.…”

Section: Critical Care Nephrology At the Uofa Edmontonmentioning

confidence: 99%

The Evolution of Critical Care Nephrology in Edmonton

Bagshaw

Gibney²

2016

Blood Purif

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The University of Alberta (UofA) in Edmonton, Canada has a rich and productive history supporting the development of critical care medicine, nephrology and the evolving subspecialty of critical care nephrology. The first hemodialysis program for patients with chronic renal failure in Canada was developed at the University of Alberta Hospital. The UofA is also recognized for its early pioneering work on the diagnosis, etiology and outcomes associated with acute kidney injury (AKI), the development of a diagnostic scheme renal allograft rejection (Banff classification), and contributions to the Renal Disaster Relief Task Force. Edmonton was one of the first centers in Canada to provide continuous renal replacement therapy. This has grown into a comprehensive clinical, educational and research center for critical care nephrology. Critical care medicine in Edmonton now leads and participates in numerous critical care nephrology initiatives dedicated to AKI, renal replacement therapy, renal support in solid organ transplantation, and extracorporeal blood purification. Critical care medicine in Edmonton is recognized across Canada and across the globe as a leading center of excellence in critical care nephrology, as an epicenter for research innovation and for training a new generation of clinicians with critical care nephrology expertise.

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“…In the patient with hemodynamic instability, CRRT is the modality of choice to clear exogenous intoxications. In addition, single-pass albumin dialysis and molecular adsorbent recirculation system can be performed to remove toxins which are highly proteinbound and do not have a very large volume of distribution such as carbamazepine, methotrexate, phenytoin, and acetaminophen [51][52][53][54][55][56]. As opposed to AKI, patients receiving dialysis for the treatment of an acute intoxication typically require a dialysis fluid or replacement fluid with therapeutic concentrations of phosphorus and potassium to avoid electrolyte abnormalities [48].…”

Section: Rrt For "Nonrenal" Indications Intoxicationsmentioning

confidence: 99%